title: Voriconazole versus natamycin as primary treatment in fungal corneal ulcers.
abstract: BACKGROUND
  To evaluate the efficacy of topical 1% voriconazole versus 5% natamycin in treatment of fungal corneal ulcers.
  
  
  METHODS
  A prospective, randomized pilot study in a tertiary care hospital.
  
  
  METHODS
  Thirty patients of microbiologically proven fungal keratitis divided randomly in two groups of 15 patients each.
  
  
  METHODS
  Two groups were treated with either 5% natamycin (group A) or 1% voriconazole (group B) topically as a primary treatment for fungal keratitis. The mean size, depth of infiltrate and LogMAR visual acuity at presentation were comparable in both groups (P > 0.05). Patients were followed up for minimum of 10 weeks or till complete resolution of ulcer, whichever was later. Cultures to identify the causative organisms were performed.
  
  
  METHODS
  Time of resolution of the ulcer.
  
  
  RESULTS
  Twenty-nine of the total 30 patients showed complete resolution. Average time of resolution and gain in LogMAR visual acuity was 24.3 days and 1.12 in group A and 27.2 days and 0.77 in group B. These were comparable in the two groups (P > 0.05%). Aspergillus spp. (40%) and Curvularia spp. (30.0%) were found to be most common isolates.
  
  
  CONCLUSIONS
  Topical 1% voriconazole was found to be safe and effective drug in primary management of fungal keratitis, its efficacy matching conventional natamycin. There was no added advantage of using topical 1% voriconazole over topical natamycin as primary treatment in fungal keratitis.
authors.affiliation: Guru Nanak Eye Centre, New Delhi, India.
authors.forename: Ritu
authors.initials: R
authors.lastname: Arora
authors.forename: Deepa
authors.initials: D
authors.lastname: Gupta
authors.forename: Jawaharlal
authors.initials: J
authors.lastname: Goyal
authors.forename: Ravinder
authors.initials: R
authors.lastname: Kaur
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003320:Corneal Ulcer / Q000188:drug therapy* / Q000382:microbiology; D004311:Double-Blind Method; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008828:Microbiological Techniques; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy* / Q000382:microbiology; D010866:Natamycin / Q000008:administration & dosage / Q000627:therapeutic use*; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D010865:Pilot Projects; D011446:Prospective Studies; D011743:Pyrimidines / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D014792:Visual Acuity; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D009883:Ophthalmic Solutions; D011743:Pyrimidines; D014230:Triazoles; D010866:Natamycin; D065819:Voriconazole