Service Pharmacie, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France.
ICBMS CNRS 5246, Campus Lyon-Tech La Doua, Université de Lyon, Lyon, France.
Ocul Immunol Inflamm. 2020 Apr 2;28(3):471-478. doi: 10.1080/09273948.2019.1571613. Epub 2019 Feb 27.
: endophthalmitis represents a therapeutic challenge, considering the inability of many antifungals to achieve adequate concentrations in the vitreous. Intravitreal injection (IVI) of antifungals (amphotericin b deoxycholate or voriconazole) is therefore recommended. Whereas amphotericin b IVI is well documented, clinical data on voriconazole IVI are limited.: This was a retrospective review IRB approved of patients receiving voriconazole IVI for endophthalmitis. Complete ophthalmological examination was completed at baseline and during follow-up.: Five patients were treated with a mean four injections [range: 2-9] of voriconazole (100 µg/0.1 mL saline). Improvement of visual acuity and disappearance of signs of infection were obtained in all patients. Safety concern including photoreceptor toxicity was not attributed to voriconazole IVI.: Voriconazole IVI demonstrated to be safe and led to a favorable clinical outcome. Thus, voriconazole IVI must be performed if endophthalmitis is suspected to increase the chance of clinical success.
眼内炎是一种治疗挑战,因为许多抗真菌药物无法在玻璃体内达到足够的浓度。因此,推荐玻璃体内注射(IVI)抗真菌药物(两性霉素 B 脱氧胆酸盐或伏立康唑)。虽然两性霉素 B IVI 已有充分的文献记载,但关于伏立康唑 IVI 的临床数据有限。
本研究回顾性分析了接受 IVI 伏立康唑治疗眼内炎的患者。在基线和随访期间完成了全面的眼科检查。
5 名患者平均接受了 4 次(范围:2-9)伏立康唑(100µg/0.1mL 生理盐水)注射。所有患者的视力均有改善,感染迹象消失。未将光感受器毒性等安全性问题归因于 IVI 伏立康唑。
IVI 伏立康唑证明是安全的,并取得了良好的临床效果。因此,如果怀疑发生眼内炎,必须进行 IVI 伏立康唑治疗,以增加临床成功的机会。