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Auteur Vinodh Kakkassery
Documents disponibles écrits par cet auteur
Ajouter le résultat dans votre panier Affiner la rechercheBeyond the Blood-retina Barrier: Intravitreal Caspofungin for Fungal Endophthalmitis : Case Report / Burkhard von Jagow in OVS : Optometry & Vision Science, vol. 97, 07 (Juillet 2020)
[article]
in OVS : Optometry & Vision Science > vol. 97, 07 (Juillet 2020)
Titre : Beyond the Blood-retina Barrier: Intravitreal Caspofungin for Fungal Endophthalmitis : Case Report Type de document : article de périodique Auteurs : Burkhard von Jagow ; Oliver Kurzai ; Vinodh Kakkassery Année de publication : 2020 Langues : Français (fre) Descripteurs (mots clés) : [Thésaurus Mesh]Infections de l'oeil
[Thésaurus Mesh]Thérapeutique
[Thésaurus Type de publication]Présentations de cas
[Thésaurus HELB]:Optique:endophtalmie fongiqueMots-clés : caspofungine Résumé : Abstract
SIGNIFICANCE
Two fungal endophthalmitis cases demonstrate safety and efficiency of intravitreal caspofungin as a new therapy option in fungal endophthalmitis.
PURPOSE
The purpose of this study was to evaluate the intravitreal application of caspofungin for the treatment of fungal endophthalmitis because rising resistance to voriconazole and amphotericin B leads to a need for new antifungal therapy options.
CASE REPORT
Initially, both patients with fungal endophthalmitis underwent pars plana vitrectomy. Microbiological analysis revealed Aspergillus terreus and Candida dubliniensis, which both possess atypical resistance patterns. Caspofungin has a low bioavailability in the eye when given systemically. It was injected intravitreally into the eyes affected by fungal endophthalmitis. An injection of 100 μg of caspofungin in a volume 0.1 mL was applied repeatedly. Clinical parameters were recorded. Both eyes were stabilized by the treatment. Finally, the intraocular infections with atypical mycotic agents were eliminated. Visual acuity improved to 0.4 logMAR (20/50 Snellen) in the first case and to 1.0 logMAR (20/200 Snellen) in the second case. During the treatment course, we have not seen any toxic effects or damage of intraocular structures related to the intravitreal administration of caspofungin.
CONCLUSIONS
In summary, intravitreal caspofungin was effective and well tolerated in both cases. Therefore, caspofungin seems to be a safe and effective intravitreal alternative to voriconazole and amphotericin B in fungal endophthalmitis.Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité aucun exemplaire Combined topical anti-inflammatory and oral acetazolamide in the treatment of central serous chorioretinopathy / Raphael Wuarin in OVS : Optometry & Vision Science, vol. 96, 07 (Juillet 2019)
[article]
in OVS : Optometry & Vision Science > vol. 96, 07 (Juillet 2019)
Titre : Combined topical anti-inflammatory and oral acetazolamide in the treatment of central serous chorioretinopathy Type de document : article de périodique Auteurs : Raphael Wuarin ; Vinodh Kakkassery ; Andrea Consigli ; Daniel Roquelaure ; Athanasios Papanastasiou ; James Scott Schutz ; Gabriele Thumann ; Argyrios Chronopoulos Année de publication : 2019 Langues : Français (fre) Descripteurs (mots clés) : [Thésaurus Mesh]:C:Choriorétinopathie séreuse centrale:Choriorétinopathie séreuse centrale / thérapie
[Thésaurus Mesh]Choriorétinopathie séreuse centrale
[Thésaurus Mesh]Épithélium pigmentaire de la rétineRésumé : SIGNIFICANCE Central serous chorioretinopathy (CSCR) is still a therapeutic challenge with no criterion standard treatment. However, anatomic changes at the level of the retinal pigment epithelium could prove of predictive value in the course of the disease for selective treatment in cases of increased risk of chronicity.
PURPOSE This pilot study analyzes the efficacy for treating acute CSCR with combined systemic acetazolamide 250 mg twice a day and nepafenac 0.1% eye drops three times a day in comparison with an untreated control group. It also evaluates the presence a pigment epithelial detachment (PED) as a risk factor for chronic CSCR.
METHODS Nineteen consecutive patients (group 1) with new or new onset of recurrent CSCR were treated with oral acetazolamide and nepafenac eye drops for at least 2 months. A control group of 14 patients (group 2) with new or new onset of recurrent CSCR were untreated while under regular observation for 4 months. Primary end points were central macular thickness and best-corrected visual acuity after 4 months. Secondary end points were complete regression of subretinal fluid at 3 months and association of PED at baseline with recurrent or chronic CSCR imaged by optical coherence tomography.
RESULTS Group 1 showed significantly faster resolution of subretinal fluid with a mean central macular thickness at 4 months of 271 ± 85 μm compared with 322 ± 79 μm for group 2 (P < .05), but with no functional benefit with a best-corrected visual acuity at 4 months of 0.8 ± 0.2 for group 1 compared with 0.9 ± 0.1 for the control group (P < .05). Patients with a small flat PED were at a higher risk of developing chronic CSCR compared with patients with a dome-shaped or no PED (P < .05).
CONCLUSIONS Central serous chorioretinopathy remains a therapeutic challenge. This pilot study shows faster resolution of subretinal fluid with treatment but without functional benefit compared with observation. The presence of small, flat PED was associated with development of chronic CSCR.Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
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