Therapeutic effect of intracameral amphotericin B injection in the treatment of fungal keratitis.
OBJECTIVE
To study the therapeutic efficacy of intracameral amphotericin B (ICAMB) injection in the treatment of fungal keratitis.


METHODS
Fourteen patients with fungal keratitis received ICAMB, 10 microg/0.1 mL (group A), and 17 patients received conventional treatment only (group B). Visual acuity, time to hypopyon disappearance, time to epithelial defect closure, time to final improvement, and final outcome were analyzed and compared between the 2 groups. The concentration of amphotericin B in the aqueous humor after injection was measured using high-performance liquid chromatography.


RESULTS
The mean final visual acuity (log MAR) was 1.6 +/- 1.1 in group A and 1.3 +/- 1.4 in group B (P = 0.24). The mean time to disappearance of hypopyon, epithelial defect closure, and final improvement was 9.4 +/- 9.4, 19.8 +/- 10.4, and 26.6 +/- 9.2 days in group A and 26.7 +/- 21.3 (P = 0.03), 32.6 +/- 22.8 (P = 0.08), and 52.8 +/- 38.2 days (P = 0.04) in group B, respectively. At the last follow-up, treatment success was achieved in 92.9% of group A and 82.4% of group B (P = 0.38). The mean concentration of intracameral amphotericin B was 601.6 +/- 51.3 ng/mL at 6 hours, 98.8 +/- 43.1 ng/mL at 1 day, 57.0 +/- 11.6 ng/mL at 3 days, and 52.3 +/- 8.3 ng/mL at 7 days after injection.


CONCLUSIONS
ICAMB seems to be effective in reducing time to disappearance of hypopyon and final improvement in the treatment of fungal keratitis.
Yoon
Kyung-Chul
KC
Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea. kcyoon@chonnam.ac.kr
Jeong
In-Young
IY
Im
Seong-Kyu
SK
Chae
Hong-Jae
HJ
Yang
Sung-Yeul
SY
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000867:Anterior Chamber / Q000187:drug effects*; D000935:Antifungal Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001082:Aqueous Humor / Q000378:metabolism; D001682:Biological Availability; D002851:Chromatography, High Pressure Liquid; D003320:Corneal Ulcer / Q000188:drug therapy* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
D000935:Antifungal Agents; D000666:Amphotericin B