Therapeutic effect of intracameral amphotericin B injection in the treatment of fungal keratitis

• Published in: Cornea Vol. 26; no. 7; p. 814
• Main Authors: Yoon, Kyung-Chul, Jeong, In-Young, Im, Seong-Kyu, Chae, Hong-Jae, Yang, Sung-Yeul
• Format: Journal Article
• Language: English
• Published: United States 01.08.2007
• Subjects: Administration, Topical; Adult; Aged; Aged, 80 and over; Amphotericin B - pharmacokinetics; Amphotericin B - therapeutic use; Anterior Chamber - drug effects; Antifungal Agents - pharmacokinetics; Antifungal Agents - therapeutic use; Aqueous Humor - metabolism; Biological Availability; Chromatography, High Pressure Liquid; Corneal Ulcer - drug therapy; Corneal Ulcer - microbiology; Eye Infections, Fungal - drug therapy; Eye Infections, Fungal - microbiology; Female; Fungi - isolation & purification; Humans; Injections; Male; Middle Aged; Pilot Projects; Retrospective Studies; Treatment Outcome; Visual Acuity
• ISSN: 0277-3740
• DOI: 10.1097/ICO.0b013e31806c791e

To study the therapeutic efficacy of intracameral amphotericin B (ICAMB) injection in the treatment of fungal keratitis. 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. 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. ICAMB seems to be effective in reducing time to disappearance of hypopyon and final improvement in the treatment of fungal keratitis.