Exogenous fungal endophthalmitis

Abstract

Exogenous fungal endophthalmitis is usually a consequence of keratitis, a penetrating injury to the globe, or eye surgery. Most cases are due to molds, especially Aspergillus species and Fusarium species. Candida species are much less likely than molds to cause exogenous endophthalmitis. Mold infections are more difficult to treat than Candida infections. Exogenous mold endophthalmitis usually requires therapy with intraocular antifungal agents, vitrectomy, and systemic antifungal agents. Voriconazole, given by intraocular injection and orally, has assumed an increasingly important role in treating exogenous fungal endophthalmitis. Voriconazole achieves excellent concentrations in the aqueous and vitreous, and most molds and Candida species are susceptible to this agent. In spite of the use of intraocular and systemic antifungal agents, outcomes for exogenous mold endophthalmitis are often poor.