Yadav Harshali Manish, Thomas Boben, Thampy Cherian, Panaknti Tandava Krishnan
Department of Ophthalmology, Kerala Institute of Medical Science, P.B.No.1, Anayara P.O, Trivandrum, Kerala, India.
Department of Cancer Care, Kerala Institute of Medical Science, P.B.No.1, Anayara P.O, Trivandrum, Kerala, India.
Indian J Ophthalmol. 2017 Jun;65(6):529-531. doi: 10.4103/ijo.IJO_781_16.
We report a case of Candida albicans endogenous endophthalmitis treated with intravitreal caspofungin. The patient was a known case of acute lymphoblastic leukemia on chemotherapy and presented to us with features suggestive of endogenous endophthalmitis. He was treated initially with intravenous (IV) caspofungin and intravitreal amphotericin B. Patients condition worsened after IV caspofungin was replaced by amphotericin B necessitating a core vitrectomy. The patient was given the option of off-label caspofungin intravitreal injection for which the patient consented. There was a gradual improvement in the clinical picture. The situation worsened after the injections were stopped necessitating a revitrectomy. The study demonstrates the clinical efficacy of intravitreal caspofungin for the first time in human eyes.
我们报告了一例接受玻璃体内卡泊芬净治疗的白色念珠菌性内源性眼内炎病例。该患者是一名已知的正在接受化疗的急性淋巴细胞白血病患者，因出现提示内源性眼内炎的症状前来就诊。他最初接受了静脉注射卡泊芬净和玻璃体内注射两性霉素B治疗。在静脉注射卡泊芬净被两性霉素B替代后，患者病情恶化，需要进行玻璃体切割术。患者被给予玻璃体内注射卡泊芬净（未按药品说明书用药）的选择，患者表示同意。临床情况逐渐改善。停止注射后病情恶化，需要再次进行玻璃体切割术。该研究首次证明了玻璃体内注射卡泊芬净在人眼中的临床疗效。
