A PILOT STUDY OF INTRASTROMAL INJECTION OF AMPHOTERICIN B 0.0005% IN FUNGAL KERATITIS

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Date
2011
Authors
YANTI, MUSLIKHAN
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Pusat Pengajian Sains Perubatan Universiti Sains Malaysia
Abstract
Objective: The objective of this study is to determine the effectiveness of intrastromal Amphotericin B 0.0005% injection in human fungal keratitis Methodology: Patients with fungal keratitis diagnosed with laboratory evidence of fungal elements in Gram stain and positive fungal culture or presumed fungal keratitis on clinical grounds were recruited for this study. Injection of amphotericin B 0.0005% was carried out in ten patients (intervention group) and ten patients received standard topical antifungals (control group). Serial clinical examination was carried out on day 0 (day of initiation of treatment and intervention), day 3, day 5, day 7, day 14 and day 21. The parameters measured were the visual acuity, the size of epithelial defect, the size of stromal abscess, the depth of ulcer and the level of infiltrate. Descriptive analysis was executed due to the small sample size. Results: About 30% of patients with very poor visual acuity had improved vision to good visual acuity in the intervention group. Complete re-epithelialisation was seen in 30% of patients in the intervention group compared to 20% in the control group. Resolution of stromal abscess and reduction in the level of stromal infiltrate were seen earlier in the intervention group. 40% of subjects in the intervention group showed complete healing of the stromal compared to 10% in control group. Conclusion: Intrastromal injection of amphotericin B 0.0005% (5μg/ml) was found to be effective in treating fungal keratitis in human.
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Ophthalmology
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