Efficacy of Intracameral Amphotericin B Injection in the Management of Refractory Keratomycosis and Endophthalmitis

Yilmaz, Safiye; Ture, Melih; Maden, Ahmet

doi:10.1097/ico.0b013e318030767e

Cited by 57 publications

(35 citation statements)

References 17 publications

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“…Voriconazole has optimal activity against fungi that are resistant to amphotericin B and itraconazole. (6,7,8) Our study Causative fungi were Fusarium in 50.0%, Aspergillus in 40.0% and Candida in 10.0% correlates with the studies of Bharathi MJ, et al (14) of Fusarium 42.82% followed by Aspergillus of 26.0%. and Gopinathan U, et al (15) of Fusarium 37.2% followed by Aspergillus of 30.7%.…”

Section: Discussionsupporting

confidence: 71%

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Intracameral and Intracorneal Voriconazole in Deep Keratomycosis With Endothelial Plaque

Killani¹,

Atti²,

Gupta³

et al. 2015

jemds

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Fungal keratitis, one of the major causes of ophthalmic mycosis is second only to cataract as the most common cause of blindness worldwide. OBJECTIVEThe aim was to study the intracorneal and intracameral Voriconazole in deep keratomycosis with endothelial plaque. MATERIALS AND METHODSThis was a study in the Cornea Clinic of Sarojini Devi Eye Hospital and Regional Institute of Ophthalmology, a Tertiary Care Teaching Hospital of Osmania Medical College (Govt.), Hyderabad, over a period from September 2012 to August 2014. The study group included 30 patients who were diagnosed clinically and microbiologically (+ve smear and culture) as fungal corneal ulcers with deep stromal infiltrates and endothelial plaque not responding to routine antifungal drugs and given voriconazole intracorneally and intracamerally.Data of patient's age and sex and history of corneal trauma with type of the agents were noted. The time of healing of the ulcer with the scar formation after intracorneal and intracameral voriconazole was noted and the visual acuity was recorded after the healing of the corneal ulcer. RESULTSThirty eyes of 30 patients with deep keratomycosis with endothelial plaque were evaluated; 19(63.3%) were Males and 11(36.7%) were Females. ; 12 (40.0%) in 6-8 wks., 5(16.7%) in 8-10 wks., and 4(13.3%) in 10-12 wks.; 25(83.3%) which were healed by corneal scarring were given 1 (One) intracorneal and intracameral injection of Voriconazole. The 5(16.7%) did not respond to 2 (Two) intracorneal and intracameral voriconazole injections, progressed to corneal perforations and were treated by Therapeutic Penetrating keratoplasty. Visual acuity was <3/60 in 18(60.0%) and 3/60 to <6/60 in 12(40.0%), and <3/60 in 3(10.0%), 3/60-<6/60 in 13(43.3%) and 6/60-<6/18 in 9(30.0%) before and after the intracorneal and intracameral voriconazole respectively. CONCLUSIONSTargeted delivery of Intracorneal and Intracameral Voriconazole was effective with a better visual outcome and a significant reduction in healing time in deep keratomycosis with endothelial plaque not responding to routine antifungal therapy.

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Section: Discussionsupporting

confidence: 71%

“…Intracorneal and intracameral injections of amphotericin B. (6,7,8,9) and Intracameral Amphotericin-B. (6,8) were tried in fungal keratitis.…”

Section: Introductionmentioning

confidence: 99%

Intracameral and Intracorneal Voriconazole in Deep Keratomycosis With Endothelial Plaque

Killani¹,

Atti²,

Gupta³

et al. 2015

jemds

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“…Even with Candida species, 109 of 1,763 isolates (6.2%) were reported to have voriconazole MICs of Ն4 g/ml in refractive cases or immunocompromised patients, suggesting an increasing demand for the direct injection of voriconazole (13). Besides, in cases of deep mycosis, such as fungal hypopyon, intracameral injection may be required, because topically administered drugs poorly penetrate the intact corneal epithelium (35).…”

Section: Discussionmentioning

confidence: 99%

Cytotoxicity of Voriconazole on Cultured Human Corneal Endothelial Cells

Han

Shin

Hyon

et al. 2011

Antimicrob Agents Chemother

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The purpose of the present study was to evaluate the toxicity of voriconazole on cultured human corneal endothelial cells (HCECs). HCECs were cultured and exposed to various concentrations of voriconazole (5.0 to 1,000 g/ml). Cell viability was measured using a Cell Counting Kit-8 (CCK-8) and live/dead viability/ cytotoxicity assays. Cell damage was assessed using phase-contrast microscopy after 24

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“…There are reports of cataract after administration and of a transient increase in chamber reaction within 24 hours due to the immunopotentiating effect of AMB. Other side effects such as iritis and corneal oedema may occur, but they are reversible (27)(28)(29)(30)(31) . For the treatment of fungal endophthalmitis, intravitreal injection of AMB is the therapy of choice.…”

Section: -Amphotericin Bmentioning

confidence: 99%

Antifúngicos em infecções oculares: drogas e vias de administração

Müller¹,

Kara‐José²,

Castro³

2013

Rev. bras.oftalmol.

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RESUMOO tratamento das infecções oculares por fungos representa um desafio à prática oftalmológica. Para obtermos resposta terapêutica adequada, além do uso da droga correta, é necessária a administração desta de forma eficaz. Este manuscrito reúne informações a respeito das principais drogas antifúngicas utilizadas em infecções oculares, suas concentrações e principais vias de administração.

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Efficacy of Intracameral Amphotericin B Injection in the Management of Refractory Keratomycosis and Endophthalmitis

Abstract: Intracameral amphotericin B may be an effective adjunctive treatment of fungal keratitis unresponsive to conventional antifungal therapy, although cataract may occur.

Cited by 57 publications

References 17 publications

Intracameral and Intracorneal Voriconazole in Deep Keratomycosis With Endothelial Plaque

Intracameral and Intracorneal Voriconazole in Deep Keratomycosis With Endothelial Plaque

Cytotoxicity of Voriconazole on Cultured Human Corneal Endothelial Cells

Antifúngicos em infecções oculares: drogas e vias de administração

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