Exogenous Fungal Endophthalmitis: Clues to Aspergillus Aetiology with a Pharmacological Perspective
Open Access
- 30 December 2020
- journal article
- review article
- Published by MDPI AG in Microorganisms
- Vol. 9 (1), 74
- https://doi.org/10.3390/microorganisms9010074
Abstract
Exogenous fungal endophthalmitis (EXFE) represents a rare complication after penetrating ocular trauma of previously unresolved keratitis or iatrogenic infections, following intraocular surgery such as cataract surgery. The usual latency period between intraocular inoculation and presentation of symptoms from fungal endophthalmitis is several weeks to months as delayed-onset endophthalmitis. Aspergillus spp., is the most common causative mould pathogen implicated in this ocular infection and early diagnosis and prompt antimicrobial treatment, concomitantly in most cases with expert surgical attention, reduce unfavorable complications and increase the possibility of eye function preservation. Topical, intravitreal and systemic antifungal molecules are the mainstay of a medical approach to the disease and azoles, polyenes and in particular cases echinocandins are the pharmacological classes most commonly used in clinical practice. This review discusses pharmacokinetics and pharmacodynamic of antifungal agents in their principal modes of administration with a focus on their ability to achieve high drug concentration in the vitreous and ocular tissues.Keywords
This publication has 59 references indexed in Scilit:
- The microbiology of endophthalmitis: global trends and a local perspectiveEuropean Journal of Clinical Microbiology & Infectious Diseases, 2012
- Delayed- Versus Acute-Onset Endophthalmitis After Cataract SurgeryAmerican Journal of Ophthalmology, 2012
- Endophthalmitis after cataract surgery in China, 1995–2009Journal of Cataract & Refractive Surgery, 2011
- Ocular Fungal InfectionsCurrent Eye Research, 2010
- Intracameral Voriconazole Injection in the Treatment of Fungal Endophthalmitis Resulting From KeratitisAmerican Journal of Ophthalmology, 2010
- Microbiological profile of culture-proven cases of exogenous and endogenous endophthalmitis: a 10-year retrospective studyEye, 2008
- The Effects of Caspofungin and Voriconazole in Experimental Candida EndophthalmitisCurrent Eye Research, 2007
- Post-traumatic fungal endophthalmitis—a prospective studyEye, 2006
- Endophthalmitis after pars plana vitrectomy: Incidence, causative organisms, and visual acuity outcomesAmerican Journal of Ophthalmology, 2004
- Invasive AspergillosisClinical Infectious Diseases, 1998