The Role of Vitrectomy in the Management of Fungal Endophthalmitis

Chee, Yewlin E.; Eliott, Dean

doi:10.1080/08820538.2016.1228396

Cited by 24 publications

(30 citation statements)

References 77 publications

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“…We also found that fungal endophthalmitis can present with mass lesions in the anterior chamber and that fungi can hide and grow in the space behind the iris. Vitrectomy can remove fungal pathogens and toxins from the vitreous and can be combined with other intraocular procedures, such as lensectomy, the removal of an intraocular foreign body, and silicone oil tamponade [ 11 ]. The indications for lensectomy include traumatic lens opacity and purulent exudation on the lens surface [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Vitrectomy combined with intravitreal antifungal therapy for posttraumatic fungal endophthalmitis in eastern China

et al. 2020

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Background To evaluate the effect and prognostic factors of vitrectomy combined with intravitreal antifungal therapy for posttraumatic fungal endophthalmitis in Eastern China. Methods We retrospectively reviewed the medical records of patients who developed fungal endophthalmitis after penetrating ocular trauma at an ophthalmic center in Eastern China. All patients underwent vitrectomy and intravitreal injection of antifungal drugs. Results Thirty-five patients (35 eyes) were included. Twelve eyes suffered plant trauma, 17 eyes metal trauma, and 6 eyes other trauma. The culture results for all 35 eyes showed filamentous fungi, including Aspergillus in 26 eyes (74.3%). Twenty-three eyes underwent vitrectomy once and 12 eyes were treated twice. Four eyes were iridectomized because of a fungal lesion behind the iris. Fungal endophthalmitis was effectively controlled in 33 eyes (94.3%), whereas 2 eyes were ultimately enucleated. Visual acuity was significantly better after treatment than before treatment (P = 0.0006). According to the preoperative vision, the affected eyes were divided into two groups: group 1A (light perception) and group 1B (better than light perception). The final visual acuity in group 1B was significantly better than that in group 1A (P = 0.0289). Conclusions Vitrectomy combined with intravitreal antifungal therapy is an effective treatment for posttraumatic fungal endophthalmitis. Preoperative visual acuity is a significant factor affecting the prognosis of visual acuity.

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Section: Discussionmentioning

confidence: 99%

Vitrectomy combined with intravitreal antifungal therapy for posttraumatic fungal endophthalmitis in eastern China

et al. 2020

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“…While the occurrence of fungal endophthalmitis is rare, timely diagnosis and treatment is required to prevent vision impairment, including blindness (22). Treatment of fungal endophthalmitis is a challenge, as patients are often asymptomatic and the disease onset is delayed (4).…”

Section: Discussionmentioning

confidence: 99%

Isavuconazole for Treatment of Experimental Fungal Endophthalmitis Caused by Aspergillus fumigatus

Guest

Singh

Revankar

et al. 2018

Antimicrob Agents Chemother

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Fungal endophthalmitis remains a significant cause of vision impairment and blindness. Moreover, the prognosis is poor, in part due to delay in diagnosis and to limited availability of effective antifungal agents with good ocular penetration. Thus, it is imperative to evaluate the therapeutic efficacy in fungal endophthalmitis of newer antifungal agents. In this study, we assessed the efficacy of isavuconazole in treating endophthalmitis in an exogenous mouse model of the disease. Briefly, endophthalmitis was induced by intravitreal (IVT) injection of spores into immunocompetent C57BL/6 (B6) mouse eyes. Mice were randomized into five groups that received isavuconazole via (i) oral gavage, (ii) IVT injections, (iii) intravenous injection, (iv) IVT injection followed by oral gavage, and (v) IVT injection followed by intravenous injection. Our data showed that isavuconazole treatment via all routes reduced fungal burden in -infected eyes. This coincided with the preservation of retinal structural integrity (histology analysis) and retinal function (electroretinography [ERG] analysis), resulting in significantly improved disease outcome. Furthermore, isavuconazole treatment reduced the levels of inflammatory cytokines (tumor necrosis factor α [TNF-α], interleukin 1β [IL-1β], and IL-6) and cellular infiltration in the eyes. Notably, oral administration of isavuconazole was as effective in ameliorating endophthalmitis as intravitreal injection of the drug. Collectively, our study demonstrates that isavuconazole is effective in treating endophthalmitis in mice, indicating its potential use in human ocular infections.

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“…19 Fungal endoftalmiden şüpheleniliyorsa, özellikle ön kamara ve vitreus parasentez sıvısı analizi negatif ise tanı için vitrektomi düşünülebilir. 20 Olgularımızda sırasıyla kan ve idrar kültürü, vitreus örneği kültürü, kan kültürü ve vitreus örneği gram boyaması yardımıyla tanı kondu.…”

Section: Discussionunclassified

“…PPV tanıya yardımcı olurken, vitreustaki ve diğer intraoküler yapılardaki mantarları uzaklaştırarak enfeksiyöz yükünü azaltır, vitreus opasitelerini uzaklaştırarak vizyonu iyileştirir, antifungal ajanların vitreus boşluğu, retina ve koroide difüzyonunu artırır ve vitreus dokusunu uzaklaştırarak vitreoretinal traksiyonları azaltır. 16,20,30 Seröz, traksiyonel ve regmatojen RD fungal endoftalmide tanımlanmıştır ve kötü görsel prognozla ilişkilidir. 16,31 Sonuç olarak, PPV, fungal endoftalmide RD gelişimini önlemede ve geliştiyse de tedavisinde önemli rol oynar.…”

Section: Discussionunclassified

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Results of Pars Plana Vitrectomy in Endogenous Fungal Endophthalmitis in 3 Cases

Güneş¹,

Şatırtav²,

Öztürk³

et al. 2020

Turkiye Klinikleri J Ophthalmol

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ÖZET Endojen fungal endoftalmi, fungal etkenin hematojen yolla oküler dokulara ulaşmasına bağlı gelişir. Yıkıcı oküler komplikasyonlara yol açabilen, hızlı tanı ve uygun tedavi gerektiren intraoküler bir enfeksiyondur. Endojen fungal endoftalmi tedavisi için standart rejimler sistemik antifungaller, intravitreal antifungal enjeksiyonlar ve pars plana vitrektomidir. Bu çalışmada; bilateral endojen fungal endoftalmi nedeni ile izlenen, sistemik ve/veya intravitreal antifungal tedavi alan üç olguda pars plana vitrektominin terapötik etkisinin sonuçlarının sunulması amaçlanmıştır. Anah tar Ke li me ler: Endojen endoftalmi; fungal endoftalmi; kandida endoftalmisi; vitrektomi ABS TRACT Endogenous fungal endophthalmitis occurs via hematogenous spread of fungal agents to ocular tissues. It is an intraocular infection that can result in devastating ocular complications and requires immediate diagnosis and appropriate treatment. Standard regimens for endogenous fungal endophthalmitis treatment alternatives are systemic antifungals, intravitreal antifungal injections, and pars plana vitrectomy. In this study; we aimed to present the results of the therapeutic effect of pars plana vitrectomy in three cases, who received systemic and/or intravitreal antifungal therapy for bilateral endogenous fungal endophthalmitis.

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The Role of Vitrectomy in the Management of Fungal Endophthalmitis

Cited by 24 publications

References 77 publications

Vitrectomy combined with intravitreal antifungal therapy for posttraumatic fungal endophthalmitis in eastern China

Vitrectomy combined with intravitreal antifungal therapy for posttraumatic fungal endophthalmitis in eastern China

Isavuconazole for Treatment of Experimental Fungal Endophthalmitis Caused by Aspergillus fumigatus

Results of Pars Plana Vitrectomy in Endogenous Fungal Endophthalmitis in 3 Cases

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