Endogenous Candida Endophthalmitis: Management without Intravenous Amphotericin B

Roy D. Brod, Harry W. Flynn, John G. Clarkson, Stephen C. Pflugfelder, William W. Culbertson, Darlene Miller

Research output: Contribution to journalArticle

70 Scopus citations

Abstract

Eight consecutive cases of culture-proven endogenous Candida endophthalmitis (ECE) were managed between 1980 and 1988. All patients were treated with vitrectomy and injection of intravitreal amphotericin B. Blood cultures were negative in all patients, although Candida albicans was cultured from a foot ulcer in one patient. No systemic therapy was used in three patients, three patients received oral ketoconazole, and two patients received oral flucytosine postoperatively. Intravenous amphotericin B was not used because of lack of evidence of disseminated candidiasis and the systemic toxicity associated with its use. The ECE responded favorably to treatment in all cases. Final vision was better in patients with a shorter interval between onset of symptoms and initiation of antifungal therapy. Posttreatment visual acuities were: four eyes ≥ 20/50, two eyes at 20/80 to 20/200, and two eyes < 5/200. This series showed that ECE without evidence of disseminated disease can be treated successfully with vitrectomy and intravitreal amphotericin B.

Original languageEnglish (US)
Pages (from-to)666-674
Number of pages9
JournalOphthalmology
Volume97
Issue number5
DOIs
StatePublished - Jan 1 1990

ASJC Scopus subject areas

  • Ophthalmology

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