Endogenous fungal endophthalmitis
From IDWiki
Management
Tissue Penetration
- Penetration of antifungals into the vitreous is variable, though increases with inflammation
- Amphotericin B has poor penetration into the vitreous, with liposomal better than non-liposomal
- It can be given intravitreally 5 to 10 μg of AmB-D as adjunctive therapy
- Flucytosine has excellent penetration
- Azoles
- Fluconazole has good penetration, reaching intravitreal levels of 70% those in plasma
- Voriconazole reaches 38% in non-inflamed eyes, and can also be given intravitreally up to 25 μg/mL
- Unclear other azoles
- Echinocandins have poor ocular penetration and are not recommended
