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Outcomes of Primary Transconjunctival 23-Gauge Vitrectomy in the Diagnosis and Treatment of Presumed Endogenous Fungal Endophthalmitis |
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| Authors: | Antony William Martin S. Spitzer Christoph Deuter Gunnar Blumenstock Michael Partsch Bogomil Voykov |
| Affiliation: | 1. Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany;2. Department of Clinical Epidemiology and Applied Biometry, University of Tuebingen, Tuebingen, Germany |
| 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 |