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[Vitreous surgery for mycotic endophthalmitis]
1Department of Ophthalmology, Teine Keijinkai Hospital.
[Hokkaido Igaku Zasshi] the Hokkaido Journal of Medical Science
|July 1, 1993
Summary
Early antifungal therapy is crucial for mycotic endophthalmitis. For persistent cases, prompt vitrectomy before retinal detachment is essential for better visual outcomes in fungal eye infections.
Area of Science:
- Ophthalmology
- Mycology
Background:
- Mycotic endophthalmitis presents a significant challenge in ocular infections.
- Fungal invasion of the eye requires timely and effective treatment strategies.
Observation:
- One patient with mycotic endophthalmitis showed improvement with systemic antifungal agents (miconazole and fluconazole).
- Seven patients underwent vitrectomy due to persistent intraocular inflammation and vitreous opacities caused by fungal colonies.
Findings:
- Vitrectomy improved visual acuity and ophthalmoscopic findings in three cases without retinal detachment.
- Vitrectomy was ineffective in two cases with pre-retinal membranes causing tractional retinal detachment.
- Fungal isolation was rare in later stages, despite dense vitreous opacities.
Implications:
- Prompt initiation of antifungal therapy is recommended for suspected mycotic endophthalmitis.
- Vitrectomy should be considered before the development of retinal detachment in non-responsive cases.
- Inflammatory and fibrotic processes complicate retinal changes, emphasizing the need for early intervention.