Efficacy of intracameral amphotericin B injection in the management of refractory keratomycosis and endophthalmitis.

Abstract

PURPOSE:

To evaluate the efficacy of intracameral amphotericin B injection in the adjunctive management of keratomycosis with probable intraocular extension not responding to conventional antifungal therapy.

METHODS:

Fourteen eyes of 12 patients with fungal keratitis that did not respond to initial treatment with topical and intravenous fluconazole and oral itraconazole were treated with up to 5 intracameral injections of 5 microg of amphotericin B. Six eyes received one injection, and 8 required subsequent injections.

RESULTS:

Twelve eyes responded to amphotericin B therapy, including 5 that healed with a central corneal scar and 8 that healed with a peripheral opacity. Two eyes progressed to evisceration. Four eyes developed anterior subcapsular cataract after intracameral amphotericin B.

CONCLUSIONS:

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

• Authors: Safiye Yilmaz, Melih Ture, Ahmet Maden
• Journal: Cornea (Cornea) Vol. 26 Issue 4 Pg. 398-402 (May 2007) ISSN: 0277-3740 [Print] United States
• PMID: 17457185 (Publication Type: Journal Article)

Chemical References

• Antifungal Agents
• Amphotericin B

Topics

• Adult
• Aged
• Amphotericin B (therapeutic use)
• Anterior Chamber (drug effects)
• Antifungal Agents (therapeutic use)
• Aspergillus (isolation & purification)
• Candida albicans (isolation & purification)
• Corneal Ulcer (drug therapy, microbiology)
• Endophthalmitis (drug therapy, microbiology)
• Eye Infections, Fungal (drug therapy, microbiology)
• Female
• Fusarium (isolation & purification)
• Humans
• Injections
• Male
• Middle Aged
• Mycoses (drug therapy, microbiology)
• Recurrence
• Retreatment
• Treatment Outcome