Intravitreal voriconazole for treatment of blastomycotic chorioretinitis in a cat
2013
Occelli, L.M. | Wolfer, J.C.
A 4-year-old neutered male domestic short hair cat was presented for blindness, anisocoria and systemic blastomycosis. Ophthalmic examination revealed bilateral retinal detachment and chorioretinitis. The left eye (OS) had a serous bullous retinal detachment and the right eye (OD) a partial retinal detachment with a subretinal granuloma. OS was enucleated and OD treated with an intravitreal injection of 150μg voriconazole and 4mg triamcinolone. Histopathology of OS confirmed blastomycotic chorioretinitis. Suppurating pyogranulomatous inflammation was present within the posterior segment with subretinal effusion and retinal detachment. Characteristic yeasts were present within the choroid, the tapetum, the sclera and the optic nerve. After the antimycotic intravitreal treatment, the retina did reattach in OD and vision returned. Chorioretinal scarring remained and a cataract developed. Routine phacoemulsification was performed. Ten months post-intravitreal antifungal treatment, OD was sighted and comfortable. The patient continued treatment with systemic antifungal medication, topical anti-glaucoma and anti-inflammatory drugs. To the best of our knowledge, this is the first case report of the use of intravitreal antifungal medication for treatment of ocular blastomycosis in a cat.
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