Treatment of Fungal Corneal Ulcers With Amphotericin B Ointment

Hirose, Hiroshi; Terasaki, Hiroko; Awaya, S; T, Yasuma

doi:10.1016/s0002-9394(14)71701-5

Cited by 31 publications

(18 citation statements)

References 5 publications

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“…Fortunately, the 0.15% solution of amphotericin B in sterile water used in clinical practice appears to be well tolerated (377,429). Topical application of 0.5% ointment may cause some conjunctival irritation (236), although a 2% ointment was reported to be well tolerated in therapy of mycotic keratitis (148). Subconjunctival injection has been reported to lead to severe toxic effects and is no longer recommended.…”

Section: Polyenesmentioning

confidence: 99%

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Current Perspectives on Ophthalmic Mycoses

2003

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Fungi may infect the cornea, orbit and other ocular structures. Species of Fusarium, Aspergillus, Candida, dematiaceous fungi, and Scedosporium predominate. Diagnosis is aided by recognition of typical clinical features and by direct microscopic detection of fungi in scrapes, biopsy specimens, and other samples. Culture confirms the diagnosis. Histopathological, immunohistochemical, or DNA-based tests may also be needed. Pathogenesis involves agent (invasiveness, toxigenicity) and host factors. Specific antifungal therapy is instituted as soon as the diagnosis is made. Amphotericin B by various routes is the mainstay of treatment for life-threatening and severe ophthalmic mycoses. Topical natamycin is usually the first choice for filamentous fungal keratitis, and topical amphotericin B is the first choice for yeast keratitis. Increasingly, the triazoles itraconazole and fluconazole are being evaluated as therapeutic options in ophthalmic mycoses. Medical therapy alone does not usually suffice for invasive fungal orbital infections, scleritis, and keratitis due to Fusarium spp., Lasiodiplodia theobromae, and Pythium insidiosum. Surgical debridement is essential in orbital infections, while various surgical procedures may be required for other infections not responding to medical therapy. Corticosteroids are contraindicated in most ophthalmic mycoses; therefore, other methods are being sought to control inflammatory tissue damage. Fungal infections following ophthalmic surgical procedures, in patients with AIDS, and due to use of various ocular biomaterials are unique subsets of ophthalmic mycoses. Future research needs to focus on the development of rapid, species-specific diagnostic aids, broad-spectrum fungicidal compounds that are active by various routes, and therapeutic modalities which curtail the harmful effects of fungus- and host tissue-derived factors

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Section: Polyenesmentioning

confidence: 99%

“…Subconjunctival injection has been reported to lead to severe toxic effects and is no longer recommended. Amphotericin B in solution or as an ointment has been used topically to treat conjunctivitis, scleritis, and keratitis (31,148,334,377,429); it is the treatment of choice for keratitis due to Candida spp. (see below).…”

Section: Polyenesmentioning

confidence: 99%

Current Perspectives on Ophthalmic Mycoses

2003

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“…10,17,36,44 If hyphae are definitely seen by microscopy, topical natamycin (5%) is the drug of choice (0.15% amphotericin B is another option). 42,45 Econazole (1%) was recommended by some workers in the 1970s, 16,46 but there are no recent reports about the use of this compound as first-line therapy for mycotic keratitis. If yeasts or pseudohyphae are seen on microscopy, topical 0.15% amphotericin B, 10,44 fluconazole 2%, 47 natamycin 5%, 10 other azoles at 1% in arachis oil, or 1% flucytosine eye drops can be used.…”

mentioning

confidence: 99%

Fungal infections of the cornea

Thomas

2003

Eye

384

292

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“…However, in corneas with intact epithelium, concentrations were low or undetectable (18)(19)(20)(21) . The drug showed good tolerability and efficiency when used both as eye drops and ointment (22,23) . Subconjunctival administration can be used in patients with low adherence to treatment, but it is limited due to reports of conjunctival necrosis, scleritis and scleral thinning (24,25) .…”

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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Treatment of Fungal Corneal Ulcers With Amphotericin B Ointment

Cited by 31 publications

References 5 publications

Current Perspectives on Ophthalmic Mycoses

Current Perspectives on Ophthalmic Mycoses

Fungal infections of the cornea

Antifúngicos em infecções oculares: drogas e vias de administração

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