TY - JOUR
T1 - Fungal endophthalmitis at the New York Eye and Ear Infirmary 1988-1995
AU - Seedor, J. A.
AU - Ritterband, D. C.
AU - Shah, M. K.
AU - Joshi, P.
AU - Koplin, R. S.
PY - 1996/2/15
Y1 - 1996/2/15
N2 - Purpose. To retrospectively study the incidence and clinical outcome of fungal endophthalmitis at our institution. Methods. The microbiologic records of all endophthalmitis cases treated between 1/88 and 11/95 were reviewed. In those cases where fungus was cultured from an intraocular specimen, a chart review was performed. Results. There were 363 cases of culture positive endophthalmitis over the study period. Of these, 8 were due to fungus (8/363 , 2.2%). 5 cases occurred postoperatively, one was related to penetrating trauma, one case was spread endogenously, and the etiology of one was unclear. 4/8 (50%) cases were Candida species. Interestingly, no filamentous fungi were isolated. All cases were treated with intravitreal amphotericin, 4/8 received multiple injections. One case had concomitant injection of miconazole. All cases underwent complete pars plana vitrectomy with 4/8 undergoing repeat pars plana vitrectomy. One case involved spread from a contiguous structure. Only one of the patients retained vision better than 20/40. Conclusions. In the New York metropolitan area, fungal endophthalmitis is a rare clinical entity. Only 8 cases were identified out of 363 culture positive endophthalmitis cases over the 7 year time period (8/363, 2.2%). Unfortunately, our database is too small to evaluate the full benefit of complete pars plana vitrectomy in fungal endophthalmitis, but it is our impression that complete vitrectomy does debulk the infectious load and speed clearing. Collaborative studies such as the EVS may help determine optimal treatment.
AB - Purpose. To retrospectively study the incidence and clinical outcome of fungal endophthalmitis at our institution. Methods. The microbiologic records of all endophthalmitis cases treated between 1/88 and 11/95 were reviewed. In those cases where fungus was cultured from an intraocular specimen, a chart review was performed. Results. There were 363 cases of culture positive endophthalmitis over the study period. Of these, 8 were due to fungus (8/363 , 2.2%). 5 cases occurred postoperatively, one was related to penetrating trauma, one case was spread endogenously, and the etiology of one was unclear. 4/8 (50%) cases were Candida species. Interestingly, no filamentous fungi were isolated. All cases were treated with intravitreal amphotericin, 4/8 received multiple injections. One case had concomitant injection of miconazole. All cases underwent complete pars plana vitrectomy with 4/8 undergoing repeat pars plana vitrectomy. One case involved spread from a contiguous structure. Only one of the patients retained vision better than 20/40. Conclusions. In the New York metropolitan area, fungal endophthalmitis is a rare clinical entity. Only 8 cases were identified out of 363 culture positive endophthalmitis cases over the 7 year time period (8/363, 2.2%). Unfortunately, our database is too small to evaluate the full benefit of complete pars plana vitrectomy in fungal endophthalmitis, but it is our impression that complete vitrectomy does debulk the infectious load and speed clearing. Collaborative studies such as the EVS may help determine optimal treatment.
UR - http://www.scopus.com/inward/record.url?scp=33750168919&partnerID=8YFLogxK
M3 - Review article
AN - SCOPUS:33750168919
SN - 0146-0404
VL - 37
SP - S773
JO - Investigative Ophthalmology and Visual Science
JF - Investigative Ophthalmology and Visual Science
IS - 3
ER -