Topical and oral voriconazole in the treatment of fungal keratitis

Korean J Ophthalmol. 2009 Mar;23(1):46-8. doi: 10.3341/kjo.2009.23.1.46. Epub 2009 Mar 9.

Abstract

We describe two patients with fungal keratitis refractory to standard antifungal therapy whose conditions were managed with voriconazole. The first case is a patient with endophthalmitis and corneal ulcer due to Candida parapsilosis after receiving a corneal transplant. The patient was treated with amphotericin but showed no signs of improvement. Topical voriconazole, oral voriconazole, and intravitreal voriconazole yielded signs of improvement. The second case is a 63-year-old male who underwent a month of empiric treatment with 0.2% topical amphotericin for fungal keratitis but showed no signs of improvement. Treatment was then provided with 1% voriconazole. Both cases showed effective treatment with voriconazole. Voriconazole may be considered as a new method to treat fungal keratitis refractory to standard antifungal therapy.

Keywords: Fungus; Keratitis; Voriconazole.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Antifungal Agents / administration & dosage*
  • Candidiasis / diagnosis
  • Candidiasis / drug therapy*
  • Candidiasis / microbiology
  • Cornea / microbiology
  • Cornea / pathology
  • Diagnosis, Differential
  • Dose-Response Relationship, Drug
  • Eye Infections, Fungal / diagnosis
  • Eye Infections, Fungal / drug therapy*
  • Eye Infections, Fungal / microbiology
  • Follow-Up Studies
  • Humans
  • Keratitis / diagnosis
  • Keratitis / drug therapy*
  • Keratitis / microbiology
  • Male
  • Middle Aged
  • Ophthalmic Solutions
  • Pyrimidines / administration & dosage*
  • Triazoles / administration & dosage*
  • Voriconazole

Substances

  • Antifungal Agents
  • Ophthalmic Solutions
  • Pyrimidines
  • Triazoles
  • Voriconazole