Intravitreal voriconazole for the treatment of Aspergillus chorioretinitis.

Abstract

The aim of this article is to report a case of Aspergillus chorioretinitis successfully treated with intravitreal voriconazole based on an interventional case report. An immunodeficient patient, 34 years old, receiving systemic antifungal treatment for 1 month for invasive aspergillosis with necrotizing pneumonia and brain metastasis, who presented with blurred vision in his left eye. Visual acuity (VA) was 20/20 in his right eye, and 8/20 in his left eye. Ophthalmological examination showed a paramacular nodular yellowish chorioretinal lesion with intraretinal hemorrhages, in the absence of vitritis or anterior uveitis. The patient was treated with one dose of intravitreal voriconazole (100 μg/0.1 ml). One week after the intravitreal injection, the patient's VA was 10/20, the retinal lesions had diminished, and the hemorrhages had disappeared. At 3-month follow-up, his AV was 20/20 with a residual retinal scar. The significant and rapid improvement in this patient suggests that early injection of intravitreal voriconazole may be the first therapeutic option in Aspergillus chorioretinitis, obviating the need for vitrectomy.

• Authors: Jorge Vila Arteaga, Mayerling Mercedes Suriano, Oana Stirbu
• Journal: International ophthalmology (Int Ophthalmol) Vol. 31 Issue 4 Pg. 341-4 (Aug 2011) ISSN: 1573-2630 [Electronic] Netherlands
• PMID: 21769537 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antifungal Agents
• Pyrimidines
• Triazoles
• Voriconazole

Topics

• Adult
• Antifungal Agents (administration & dosage)
• Aspergillosis (diagnosis, drug therapy, microbiology)
• Chorioretinitis (diagnosis, drug therapy, microbiology)
• Diagnosis, Differential
• Eye Infections, Fungal (diagnosis, drug therapy, microbiology)
• Follow-Up Studies
• Humans
• Intravitreal Injections
• Male
• Microscopy, Acoustic
• Pyrimidines (administration & dosage)
• Triazoles (administration & dosage)
• Visual Acuity
• Voriconazole