2012Case Reports in OphthalmologyOpen access

Orbital Aspergillosis: Voriconazole – The New Standard Treatment

Derek H. Ohlstein, Claudia G. Hooten, Javier Dubert Pérez, Charles L. Clark, Hazem M. Samy

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Abstract

BACKGROUND/AIM: To describe a case of invasive orbital aspergillosis and evaluate treatments and outcomes. METHODS: A case report and review of orbital aspergillosis treatment with voriconazole in the English language literature. CONCLUSION: Amphotericin B with debridement is the current standard of care for orbital aspergillosis; however, its prognosis is unfavorable. When compared to amphotericin B, voriconazole demonstrates a survival benefit, has less systemic toxicity, and is better tolerated by patients. While a prospective trial comparing amphotericin B to voriconazole in orbital aspergillosis is not feasible, there is evidence to support the use of voriconazole as primary therapy.

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BACKGROUND/AIM: To describe a case of invasive orbital aspergillosis and evaluate treatments and outcomes. METHODS: A case report and review of orbital aspergillosis treatment with voriconazole in the English language literature. CONCLUSION: Amphotericin B with debridement is the current standard of care for orbital aspergillosis; however, its prognosis is unfavorable. When compared to amphotericin B, voriconazole demonstrates a survival benefit, has less systemic toxicity, and is better tolerated by patients. While a prospective trial comparing amphotericin B to voriconazole in orbital aspergillosis is not feasible, there is evidence to support the use of voriconazole as primary therapy.

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Available abstract

BACKGROUND/AIM: To describe a case of invasive orbital aspergillosis and evaluate treatments and outcomes. METHODS: A case report and review of orbital aspergillosis treatment with voriconazole in the English language literature. CONCLUSION: Amphotericin B with debridement is the current standard of care for orbital aspergillosis; however, its prognosis is unfavorable. When compared to amphotericin B, voriconazole demonstrates a survival benefit, has less systemic toxicity, and is better tolerated by patients. While a prospective trial comparing amphotericin B to voriconazole in orbital aspergillosis is not feasible, there is evidence to support the use of voriconazole as primary therapy.

Key concepts: Voriconazole, Medicine, Aspergillosis, Amphotericin B, Mycosis, Surgery, Surgical debridement, Dermatology

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