内源性真菌性眼内炎虽少见,但如诊断及治疗不及时,可造成严重视力损害,甚至丧失眼球.高危因素及典型眼底表现是临床高度怀疑真菌性眼内炎的重要线索.应及时做玻璃体穿刺或切除获取眼内物做涂片与培养来确认致病真菌.对仅有视网膜脉络膜炎者可全身使用氟康唑.伴玻璃体混浊时,需行玻璃体内注射两性霉素或伏立康唑;如玻璃体混浊重,对药物治疗无反应或病变将累及中心凹,应及时做玻璃体手术,以挽救更多视功能.%Endogenous fungal endophthalmitis is a rare disease.Delay in diagnosis and management results in severe visual impairment even loss of globe.Existing of high risk factors, combined with typical clinical manifestations are important clues leading to highly suspicious of the disease.Timely vitreous aspiration or vitrectomy to obtain materials for smear and culture to identify the induced fungus is crucial.As for treatment: if only chorioretinitis is present, systemic antifungal drugs such as fluconazole are effective.For endophthalmitis, intravitreal amphotericin injection or voriconazole should be added.When vitritis is moderate or severe or lack of response to above medications or lesion is approaching to the foveal, immediate vitrectomy is necessary to preserve more visual function.
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