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Indian Journal of Medical Sciences, Vol. 63, No. 8, August, 2009, pp. 366-367 Letter To Editor Aspergillus endophthalmitis : Pars plana vitrectomy is an alternative Gonzalez-Granado LuisIgnacio Department of Pediatrics, Hospital 12 Octubre Correspondence Address:Av Andalucia km 5,400, 28041, Madrid nachgonzalez@gmail.com Code Number: ms09068 PMID: 19770530 DOI: 10.4103/0019-5359.55892 Sir, I read with interest a case, reported by Hosseini et al.,[1] of a 22-year-old man with allogenic orthotopic liver transplantation who suffered from Aspergillus endophthalmitis. The visual outcome of this patient was poor, despite prompt intravenous treatment with amphotericin, switched to intravenous voriconazole. I agree that in the past, Aspergillus endophthalmitis was associated with very poor visual outcome, [2] but I have some concerns about the medical management and absence of surgical treatment, which could have led to such poor visual outcome. During the last few years, considerable effort has been made to recognize the main risks for an immunocompromised patient to suffer from fungal ocular infection. There have been some reports of successful outcome only with the addition of intravitreal amphotericin as an antifungal drug, [3],[4] but better outcome has been achieved with surgery in cases of fungal endophthalmitis. It consists of pars plana vitrectomy, [5] as has been recently reported in the largest series of cases published, in which 73% (16/22) recovered visual acuity of 'counting fingers' or better. References
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