Vitrectomy combined with intravitreal antifungal therapy for posttraumatic fungal endophthalmitis in eastern China

Abstract

Abstract Background To evaluate the effect and prognostic factors of vitrectomy combined with intravitreal antifungal therapy for posttraumatic fungal endophthalmitis in Eastern China. Methods We retrospectively reviewed the medical records of patients who developed fungal endophthalmitis after penetrating ocular trauma at an ophthalmic center in Eastern China. All patients underwent vitrectomy and intravitreal injection of antifungal drugs. Results Thirty-five patients (35 eyes) were included. Twelve eyes suffered plant trauma, 17 eyes metal trauma, and 6 eyes other trauma. The culture results for all 35 eyes showed filamentous fungi, including Aspergillus in 26 eyes (74.3%). Twenty-three eyes underwent vitrectomy once and 12 eyes were treated twice. Four eyes were iridectomized because of a fungal lesion behind the iris. Fungal endophthalmitis was effectively controlled in 33 eyes (94.3%), whereas 2 eyes were ultimately enucleated. Visual acuity was significantly better after treatment than before treatment (P = 0.0006). According to the preoperative vision, the affected eyes were divided into two groups: group 1A (light perception) and group 1B (better than light perception). The final visual acuity in group 1B was significantly better than that in group 1A (P = 0.0289). Conclusions Vitrectomy combined with intravitreal antifungal therapy is an effective treatment for posttraumatic fungal endophthalmitis. Preoperative visual acuity is a significant factor affecting the prognosis of visual acuity.

Keywords

• Fungal endophthalmitis
• Penetrating ocular trauma
• Vitrectomy
• Antifungal therapy