Endophtalmies d'origine fongique: prise en charge et traitement (etude sur 9 ans). [Mycotic endophthalmitis: management and treatment (9 year study)]

Détails

ID Serval
serval:BIB_575FC762B14E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Endophtalmies d'origine fongique: prise en charge et traitement (etude sur 9 ans). [Mycotic endophthalmitis: management and treatment (9 year study)]
Périodique
Klinische Monatsblatter fur Augenheilkunde
Auteur(s)
Mora  P., Bovey  E. H., Guex-Crosier  Y.
ISSN
0023-2165 (Print)
Statut éditorial
Publié
Date de publication
04/2002
Volume
219
Numéro
4
Pages
221-5
Notes
Comparative Study
English Abstract
Evaluation Studies
Journal Article --- Old month value: Apr
Résumé
Fungal endophthalmitis: management and therapy (a 9 years experience). BACKGROUND: The development of new azoles with a better ocular bioavailability (fluconazole), and the improvement of vitrectomy has recently influenced the treatment of fungal endophthalmitis. PATIENTS AND METHODS: Records of patients treated for fungal endophthalmitis at the Jules Gonin Eye Hospital were retrospectively reviewed from January 1992 to December 2000. Initial and final visual acuities, risk factors, treatment outcomes and side effects were evaluated. Data were examined separately according to the therapy. RESULTS: 17 patients (13 males, 4 females, mean age 54 years - 27 eyes) were enrolled. 14/27 eyes were treated by oral fluconazole only (group I) for a mean duration of 5.8 +/- 3.4 months. In this series the mean initial visual acuity was 0.73 +/- 0.4 (Snellen chart), the mean final visual acuity was 0.91 +/- 0.3 in 12 eyes, hand motion and light perception in 2 eyes. 10/27 eyes (group II) with severe vitritis and/or retinal detachment underwent pars plana vitrectomy, intraocular injection of amphotericin B, and short course of oral fluconazole. The initial mean visual acuity was 0.36 +/- 0.3 in 8 eyes, hand motion in 2 eyes; the final mean visual acuity was 0.46 +/- 0.4 in 9 eyes. Vitrectomy was repeated in 3 eyes, 1 of which was subsequently enucleated due to painful phthisis. 2 patients (3 eyes) did not receive any treatment. CONCLUSION: Oral fluconazol is successful in the management of mild fungal endophthalimitis. In more severe cases, additional vitrectomy and intraocular amphotericin B injection should be considered. In such cases, pars plana vitrectomy is thought to be effective in removing the majority of the fungal charge and in allowing a direct supply of antifungal agents to the retinal infectious foci.
Mots-clé
Administration, Oral Adult Aged Aged, 80 and over Amphotericin B/*administration & dosage/adverse effects Candidiasis/diagnosis/*therapy Combined Modality Therapy Endophthalmitis/diagnosis/*therapy Eye Female Fluconazole/*administration & dosage/adverse effects Follow-Up Studies Humans Injections Male Middle Aged Retreatment Retrospective Studies *Vitrectomy
Pubmed
Web of science
Création de la notice
28/01/2008 13:40
Dernière modification de la notice
20/08/2019 15:11
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