title: Safety and efficacy of intrastromal injection of 5% natamycin in experimental fusarium keratitis.
abstract: OBJECTIVE
  To compare the efficacy of combined intrastromal injection and topical natamycin 5% to standard topical therapy alone in an experimental rabbit model of Fusarium keratitis.
  
  
  METHODS
  Fungal keratitis was induced in the right eyes of 12 New Zealand rabbits by stromal injection of Fusarium solani spore suspension into the cornea. Four days after inoculation, animals were randomly assigned to 2 different treatment groups (n=6 in each group). The study group received intrastromal injections of natamycin 5% on treatment day 1 and 4, combined with topical natamycin 5% eye drops given hourly between 8:00 and 20:00 for the first 2 days, followed by 4 times daily on days 3-11. The control group received only topical natamycin 5% at identical intervals. Eyes were examined clinically on days 1, 4, 7, and 11 for status of corneal healing, corneal vascularization, and hypopyon. Animals were sacrificed on day 11, and corneas were subjected to histopathological examination.
  
  
  RESULTS
  Both groups showed significant improvement in terms of conjunctival hyperemia, size and density of corneal infiltrate, corneal edema, and total clinical score. In the study group, there was a significant improvement in the height of hypopyon in the anterior chamber, while there was also an increased amount of vascularization.
  
  
  CONCLUSIONS
  This study showed that intrastromal injection of natamycin 5% combined with topical treatment has little beneficial effect over topical therapy in a Fusarium keratitis rabbit model. The addition of intrastromal injection should be reserved to the most severe or recalcitrant cases.
authors.affiliation: 1 Department of Ophthalmology, Meir Medical Center , Kfar Sava, Israel .
authors.forename: Michael
authors.initials: M
authors.lastname: Mimouni
authors.forename: Guy
authors.initials: G
authors.lastname: Tam
authors.forename: Yossi
authors.initials: Y
authors.lastname: Paitan
authors.forename: Dvora
authors.initials: D
authors.lastname: Kidron
authors.forename: Fani
authors.initials: F
authors.lastname: Segev
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D060585:Fusariosis / Q000188:drug therapy* / Q000473:pathology; D056965:Injections, Intraocular; D007634:Keratitis / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D010866:Natamycin / Q000008:administration & dosage* / Q000627:therapeutic use; D011817:Rabbits
chemical_list: D010866:Natamycin