Antifungal Therapy in Eye Infections: New Drugs, New Trends

Joseph, Joveeta; Sharma, Savitri

doi:10.1007/978-81-322-2782-3_9

Cited by 2 publications

(2 citation statements)

References 138 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, human cathelicidin (LL-37) has been shown to target C. albicans by binding mannan, the carbohydrate component of yeast cell walls, inhibiting fungal adhesion and aggregation in both in vitro and in vivo models ( Tsai et al, 2011 ). Current treatment for fungal keratitis includes topical natamycin, amphotericin, or, for deep penetrating hyphae, voriconazole ( Joseph and Sharma, 2016 ). However, with current increases in resistance to antifungal medications, researchers are pursuing the use of AMPs as an attractive alternative in patients undergoing corneal transplantation ( Sara et al, 2016 ).…”

Section: Functional Properties Of Antimicrobial Peptidesmentioning

confidence: 99%

Antimicrobial Peptide Expression at the Ocular Surface and Their Therapeutic Use in the Treatment of Microbial Keratitis

et al. 2022

View full text Add to dashboard Cite

Microbial keratitis is a common cause of ocular pain and visual impairment worldwide. The ocular surface has a relatively paucicellular microbial community, mostly found in the conjunctiva, while the cornea would be considered relatively sterile. However, in patients with microbial keratitis, the cornea can be infected with multiple pathogens including Staphylococcus aureus, Pseudomonas aeruginosa, and Fusarium sp. Treatment with topical antimicrobials serves as the standard of care for microbial keratitis, however, due to high rates of pathogen resistance to current antimicrobial medications, alternative therapeutic strategies must be developed. Multiple studies have characterized the expression and activity of antimicrobial peptides (AMPs), endogenous peptides with key antimicrobial and wound healing properties, on the ocular surface. Recent studies and clinical trials provide promise for the use of AMPs as therapeutic agents. This article reviews the repertoire of AMPs expressed at the ocular surface, how expression of these AMPs can be modulated, and the potential for harnessing the AMPs as potential therapeutics for patients with microbial keratitis.

show abstract

Section: Functional Properties Of Antimicrobial Peptidesmentioning

confidence: 99%

Antimicrobial Peptide Expression at the Ocular Surface and Their Therapeutic Use in the Treatment of Microbial Keratitis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Fungal infections of the eye are serious clinical concerns [2]. Keratitis is a leading cause of mo nocular blindness worldwide; it is estimated that more than half of corneal ulcers in some areas of the world are due to fungus [3][4][5]. Fungal corneal ulcers are the second most common cause of monoocular blindness in developing countries, after cataracts [6].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Voriconazole in Treating Fungal Keratitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Aryati¹,

Idrus²

2022

MPI

View full text Add to dashboard Cite

Antifungal intervention fails in approximately half of fungal keratitis patients, demonstrating its limitations. Voriconazole use for fungal keratitis has raised new interest because of its broad spectrum and good ocular penetration. However, its effectiveness has not been systematically evaluated. Here we try to clarify the benefits of voriconazole in fungal keratitis cases. Randomized controlled trials (RCTs) comparing voriconazole to placebo or other antifungal medications for fungal keratitis were searched in several databases, including PubMed, Scopus, Cochrane Library, ClinicalTrials, and WHO-ICTRP. The primary outcome that analyzed was best spectacle-corrected vision acuity (BSCVA). The secondary outcomes were treatment success, corneal perforation or need for therapeutic penetrating keratoplasty (TPK). From 621 records, nine studies were selected for analysis. The results were as follows: As an initial therapy, topical natamycin outperformed voriconazole in BSCVA (mean difference = 0.14; 95% CI 0.02 to 0.26; P =.03). Voriconazole also has a greater risk of corneal perforation or TPK than natamycin (RR=1.69; 95% CI 1.11 to 2.58; P=.02). As an adjuvant, there is no significant difference found in BSCVA, treatment success, event of corneal perforation, or need for TPK between voriconazole and the other antifungal agents (itraconazole, ketoconazole, amphotericin B, natamycin, and placebo). This study shows that voriconazole is less superior than natamycin in treating early infections of fungal keratitis. More RCTs with larger samples are needed to evaluate voriconazole's adjuvant efficacy.

show abstract

Antifungal Therapy in Eye Infections: New Drugs, New Trends

Cited by 2 publications

References 138 publications

Antimicrobial Peptide Expression at the Ocular Surface and Their Therapeutic Use in the Treatment of Microbial Keratitis

Antimicrobial Peptide Expression at the Ocular Surface and Their Therapeutic Use in the Treatment of Microbial Keratitis

Effectiveness of Voriconazole in Treating Fungal Keratitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Contact Info

Product

Resources

About