A case of endogenous Candida albicans endophthalmitis resolving with itraconazole treatment without recourse to vitrectomy

Fungal endophthalmitis is an important cause of vision loss worldwide with a large body of literature describing the treatment of the disease. The evidence supporting the use of pars plana vitrectomy in the management of fungal endophthalmitis is largely comprised of case reports and case series and demonstrates the important role of vitrectomy surgery. Vitrectomy can improve the likelihood of establishing the diagnosis, enhance the treatment of infection by removing fungal elements in the vitreous, aid in the removal of other inoculated intraocular structures, and is an important tool in the management of vision-threatening post-infectious sequelae like retinal detachment and epiretinal membrane.

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Echinocandins in Ocular Therapeutics

Patil

Majumdar

2017

Journal of Ocular Pharmacology and Therapeutics

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Fungal infections of the eye, especially fungal keratitis and endophthalmitis, are major causes of concern and if left untreated could lead to vision loss. Currently, natamycin (polyene antifungal) is the only commercially available topical agent used for the treatment of ocular fungal infections. The other antifungals, belonging to the polyene and azole classes, are used off-label in treating ocular infections and are administered topically, orally, intraocularly, or systemically. Even though their use through the different routes of administration has shown favorable outcomes, challenges such as poor ocular penetration, low bioavailability, ocular toxicity, and systemic side effects limit their utility. Hence, in search of alternative strategies, the echinocandin class of antifungals are currently being assessed for their use in ocular infections. Their evaluation in the ophthalmic arena has been propelled by their efficacy, safety, and tolerability reports in the treatment of systemic invasive fungal infections. This review compiles the reports on the ocular investigations of the 3 commercially available echinocandins-caspofungin, micafungin, and anidulafungin-to understand their potential as ocular antifungal agents.

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A case of endogenous Candida albicans endophthalmitis resolving with itraconazole treatment without recourse to vitrectomy

Cited by 4 publications

References 7 publications

Updates in Ocular Antifungal Pharmacotherapy: Formulation and Clinical Perspectives

Updates in Ocular Antifungal Pharmacotherapy: Formulation and Clinical Perspectives

The Role of Vitrectomy in the Management of Fungal Endophthalmitis

Echinocandins in Ocular Therapeutics

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