Treatment of severe fungal keratitis with subconjunctival amphotericin B.
OBJECTIVE
To report the beneficial properties of subconjunctival amphotericin B as an adjunctive therapy in patients with severe fungal keratitis.


METHODS
Case reports and review of medical literature. Four patients with advanced fungal keratitis were treated with repeated injections of subconjunctival amphotericin B in addition to topical and systemic antifungal treatment.


RESULTS
Two to 8 injections were given to each patient. All patients showed rapid clinical improvement after the injections. No serious adverse effects were observed. However, all patients experienced pain during the injections.


CONCLUSIONS
Subconjunctival injections of amphotericin B are useful as an adjunctive treatment of advanced fungal keratitis. This treatment assures compliance and may be an alternative to avoid a surgical intervention in an acute stage of advanced fungal keratitis. More cases are needed to validate our findings.
Department of Ophthalmology, Hospital I. Perrupato, Mendoza, Argentina. macarras73@gmail.com
María Alejandra
MA
Carrasco
Graciela
G
Genesoni
D000164:Acremonium / Q000302:isolation & purification; D000328:Adult; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D002175:Candida / Q000302:isolation & purification; D003228:Conjunctiva / Q000187:drug effects; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005670:Fusarium / Q000302:isolation & purification; D006801:Humans; D056965:Injections, Intraocular; D008297:Male; D009181:Mycoses / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology
D000935:Antifungal Agents; D000666:Amphotericin B