amphotericin-b and Retinal-Detachment

We report the first case of clinically diagnosed endogenous endophthalmitis caused by Histoplasma capsulatum var. capsulatum in a patient with the acquired immune deficiency syndrome.. Interventional case report and literature review.. Pars plana vitrectomy and scleral buckling procedure in the left eye with intravenous and intravitreal amphotericin in both eyes.. The clinical features, culture results, visual outcome, and complications were studied.. This case demonstrates a bilateral endophthalmitis with severe subretinal exudation, choroidal granulomas, and intraretinal hemorrhage leading to exudative bilateral retinal detachments. Vitreous cultures grew H. capsulatum var. capsulatum. Treatment consisted of intravenous amphotericin, intravitreal amphotericin (both eyes), pars plana vitrectomy (left eye), and scleral buckling procedure (left eye) with resulting counting fingers vision (right eye) and 20/300 (left eye). Four cases of Histoplasma endophthalmitis have been reported previously, all of which had a documented history of disseminated histoplasmosis and resulted in enucleation.. H. capsulatum should be considered a possible etiologic agent of endophthalmitis, especially in patients with a history of disseminated histoplasmosis and/or immune deficiency.

Topics: Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Endophthalmitis; Eye Infections, Fungal; Histoplasma; Histoplasmosis; Humans; Male; Retinal Detachment; Retinal Diseases; Scleral Buckling; Vitrectomy; Vitreous Body

Topics: Adolescent; Adult; Amphotericin B; Animals; Cataract Extraction; Child; Child, Preschool; Electrocoagulation; Eye Diseases; Eye Foreign Bodies; Female; Hemorrhage; Humans; Infant, Newborn; Male; Methicillin; Methods; Middle Aged; Postoperative Complications; Prostheses and Implants; Rabbits; Retina; Retinal Detachment; Retinal Diseases; Urokinase-Type Plasminogen Activator; Uvea; Vitreous Body

To describe the clinical courses of patients who received intravitreal injections of highly concentrated amphotericin B deoxycholate for suspected fungal endophthalmitis.. Retrospective medical record review of 3 cases of intraocular toxicity from highly concentrated amphotericin B.. The first patient developed posttraumatic endophthalmitis and received an undiluted dose (500 μg) of amphotericin B. He developed severe intraocular inflammation and required a pars plana lensectomy, vitrectomy, and scleral buckle after developing a cataract and retinal detachment. Six years later, his visual acuity stabilized at 20/30. The second patient developed endogenous endophthalmitis and was treated with 5 intravitreal injections of amphotericin B and underwent 3 surgical procedures. The surgeon later discovered that the patient had received 55 μg of amphotericin B during the second injection. Three months after the injection, the patient's visual acuity was 20/60. The third patient developed chronic postoperative endophthalmitis following cataract extraction. He received 160 μg of amphotericin B and was immediately treated with a vitreous washout. Two years later, his visual acuity improved to 20/30. The vitreous culture results were negative in each case. A key finding was that the amphotericin B solution appeared to be yellow instead of nearly colorless.. We present 3 cases of intraocular toxicity from highly concentrated amphotericin B. In every case, the overly concentrated amphotericin B solution was yellow in color. Although severe noninfectious panophthalmitis resulted in every case, the visual acuity outcomes were good. Physicians should examine the color of amphotericin B solution prior to intraocular administration. If the solution appears to be yellow, the medication should not be injected.

Topics: Aged; Amphotericin B; Antifungal Agents; Cataract; Child; Deoxycholic Acid; Drug Combinations; Endophthalmitis; Eye Infections, Fungal; Humans; Intravitreal Injections; Male; Middle Aged; Mycoses; Retinal Detachment; Retrospective Studies; Visual Acuity; Vitreous Body

A fungal infection in the right eye after retina detachment on an immunocompetent patient is reported. After surgery, she developed an infection that was empirically treated with antibiotics and corticoids. Later the patient developed another retina and choroid detachment. The infection evolved to endophthalmitis and a sample was sent to the microbiology laboratory, where Aspergillus fumigatus was isolated. In spite of treatment with intravenous and intravitreous amphotericin B, the eye was eventually removed by enucleation.

Topics: Amblyopia; Amphotericin B; Aspergillosis; Aspergillus fumigatus; Atropine; Combined Modality Therapy; Cryosurgery; Disease Susceptibility; Endophthalmitis; Eye Enucleation; Female; Humans; Immobilization; Laser Therapy; Liposomes; Mydriatics; Myopia; Prednisone; Retinal Detachment; Surgical Wound Infection; Tobramycin; Vitrectomy

A case of optic disk neovascularization is reported in a 30-year-old female heroin addict with suspected fungal endophthalmitis treated with an intravitreal injection of amphotericin B and fluconazole (200mg/day). Membrane healing was characterized by densification and contraction leading to tractional retinal detachment; excision by vitrectomy was required. Electron microscopy analysis of the membrane removed the tenth month revealed a poorly vascularized fibrous tissue infiltrated by chronic inflammatory cells. Visual improvement was poor owing to a postoperative macular disorder and a full-thickness retinal scar.

Topics: Adult; Amphotericin B; Antifungal Agents; Endophthalmitis; Eye Infections, Fungal; Female; Fluconazole; Humans; Injections; Neovascularization, Pathologic; Optic Disk; Retinal Detachment; Vitrectomy

To report two young healthy women who developed endogenous Candida endophthalmitis after undergoing surgically induced abortion.. Case reports.. In two eyes of two patients, a diagnosis of Candida endophthalmitis was established by typical fundus appearance, positive vaginal culture, and, in one case, positive vitreous culture. After vitrectomy and intravitreal amphotericin B injection, one eye of one patient had a best-corrected visual acuity of 20/200, whereas one eye of one patient, who had systemic corticosteroid treatment before the correct diagnosis, developed recurrent retinal detachment and a best-corrected visual acuity of counting fingers.. Induced abortion may cause endogenous Candida endophthalmitis in young healthy pregnant women. Systemic corticosteroid treatment may increase the risk of endophthalmitis.. Reported, in this article, are the cases of two young women who developed endogenous Candida endophthalmitis after induced abortion. Both women experienced transient fever, chills, and abdominal pain after the abortion and were given antibiotics. The diagnosis of endophthalmitis was established on the basis of typical fundus appearance, positive vaginal culture, and (in one case) positive vitreous culture. In the first woman, who received vitrectomy and intravitreal amphotericin B injection, the affected eye had a best corrected visual acuity of 20/200. In the second woman, who was given systemic corticosteroid treatment before the correct diagnosis was reached, recurrent retinal detachment developed and the best corrected visual acuity was counting fingers. It appears that Candida organisms harbored in the genital tract are directly inoculated into the venous system during induced abortion. Once in the blood, if sufficient fungal load is present, Candida albicans tends to localize in the choroid and to spread toward the retina and vitreous cavity. The immunosuppressive effect of corticosteroids further increases the risk of endophthalmitis.

Topics: Abortion, Induced; Adult; Amphotericin B; Antifungal Agents; Candida albicans; Candidiasis; Endophthalmitis; Eye Infections, Fungal; Female; Fundus Oculi; Humans; Pregnancy; Recurrence; Retinal Detachment; Vagina; Vaginal Smears; Visual Acuity; Vitrectomy; Vitreous Body

Topics: Amphotericin B; Candidiasis; Chorioretinitis; Eye Infections, Fungal; Humans; Retinal Detachment; Visual Acuity

Topics: Aged; Alternaria; Amphotericin B; Endophthalmitis; Eye Infections, Fungal; Female; Flucytosine; Humans; Lenses, Intraocular; Retinal Detachment; Visual Acuity; Vitrectomy; Vitreous Body

The retinal toxicity of intravitreally administered amphotericin B was compared in non-vitrectomised versus vitrectomised rabbit eyes. Doses of 5 and 10 micrograms in both groups resulted in transient vitritis but had no effect on electroretinograms. Histopathological examination four weeks after injection showed vitreous cells and minimal areas of retinal necrosis in both groups at 5 or 10 micrograms doses. At these doses vitrectomy did not modify the retinotoxic effects of intravitreally administered amphotericin B. At higher doses marked toxicity was found in both vitrectomised and non-vitrectomised groups.

Topics: Amphotericin B; Animals; Dose-Response Relationship, Drug; Electroretinography; Necrosis; Rabbits; Retina; Retinal Detachment; Retinal Diseases; Vitrectomy; Vitreous Body

Topics: Amphotericin B; Child; Cladosporium; Eye Diseases; Humans; Male; Mycoses; Retinal Detachment; Vitreous Body

Topics: Amphotericin B; Animals; Cataract; Dose-Response Relationship, Drug; Female; Inflammation; Injections; Male; Necrosis; Rabbits; Retina; Retinal Detachment; Retinal Diseases; Retinal Hemorrhage; Time Factors; Vitreous Body

Topics: Amphotericin B; Animals; Deoxycholic Acid; Electroretinography; Fundus Oculi; Injections; Necrosis; Rabbits; Retina; Retinal Detachment; Sodium; Vitreous Body

Topics: Agglutination Tests; Amphotericin B; Antigens; Blindness; Cataract; Cerebrospinal Fluid; Cryptococcosis; Cryptococcus; Culture Media; Humans; Hypertonic Solutions; Male; Methods; Middle Aged; Retinal Detachment; Rubber; Sucrose; Triamcinolone; Uveitis