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. 2017 Apr;25(2):239-245.
doi: 10.3109/09273948.2015.1115080. Epub 2016 Jan 30.

Outcomes of Primary Transconjunctival 23-Gauge Vitrectomy in the Diagnosis and Treatment of Presumed Endogenous Fungal Endophthalmitis

Antony William  1 , Martin S Spitzer  1 , Christoph Deuter  1 , Gunnar Blumenstock  2 , Michael Partsch  1 , Bogomil Voykov  1 , Focke Ziemssen  1 , Karl Ulrich Bartz-Schmidt  1 , Deshka Doycheva  1
Affiliations

Outcomes of Primary Transconjunctival 23-Gauge Vitrectomy in the Diagnosis and Treatment of Presumed Endogenous Fungal Endophthalmitis

Antony William et al. Ocul Immunol Inflamm. 2017 Apr.

Abstract

Purpose: To report the outcomes of primary transconjunctival 23-gauge (23-G) vitrectomy in the diagnosis and treatment of presumed endogenous fungal endophthalmitis (EFE).

Methods: Retrospective analysis of patients with EFE who underwent diagnostic transconjunctival 23-G vitrectomy at a tertiary referral center.

Results: Nineteen eyes of 15 patients with EFE were included in the study. Four patients had bilateral and 11 patients unilateral disease. Sixteen eyes of 15 patients underwent 23-G vitrectomy to confirm the diagnosis using vitreous culture, polymerase chain reaction, and histopathologic examinations. All affected eyes were treated with intravitreal amphotericin B 5 µg/0.1 mL. Fourteen patients received additional systemic antifungal therapy. Diagnostic 23-G vitrectomy confirmed the diagnosis of EFE in 75% of the eyes (12/16). Candida was found to be a causative agent in 62.5% and Aspergillus in 12.5% of the eyes. Retinal detachment was the most common complication (42% of eyes).

Conclusions: EFE can be easily confirmed using primary 23-G vitrectomy.

Keywords: Amphotericin B; diagnosis; endogenous fungal endophthalmitis; transconjunctival 23-gauge vitrectomy; treatment.

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