| Risk Factors Affecting Efficacy of Intracameral Amphotericin Injection in Deep Keratomycosis. |
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Je Hyun Seo, Won Ryang Wee, Jin Hak Lee, Mee Kum Kim |
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. kmk9@snu.ac.kr
2Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea.
3Department of ophthalmology, Seoul National University Bundang Hospita, Seoul, Korea. |
| 진균 감염 시 전방 내 암포테리신 주입 치료 성적에 관련된 위험 인자 분석 |
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서제현1,2,위원량1,2,이진학1,3,김미금1,2 |
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Department of Ophthalmology, Seoul National University College of Medicine1, Seoul, Korea Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute2, Seoul, Korea Department of ophthalmology, Seoul National University Bundang Hospita3, Seoul, Korea |
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Correspondence:
Mee Kum Kim, M.D. |
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| Abstract |
PURPOSE
To investigate the clinical efficacy of intracameral amphotericin injection and to evaluate risk factors affecting primary treatment success in fungal infection invading the anterior segment of the eye. METHODS: Twenty-six eyes of 26 patients diagnosed with fungal infection in the anterior segment were studied. The initial treatment regimen was a topical 0.15% amphotericin application and itraconazole oral administration after culture. Amphotericin (5 ug/0.1 ml, 0.1 cc) was repeatedly injected intracamerally when the infection intensified. Penetrating keratoplasty was conducted for eyes unresponsive to intracameral amphotericin injection. The relative risk ratios of ulcer size, infiltration depth, culture positivity, and hypopyon were compared in each treatment group to evaluate the treatment response. RESULTS: Of patients with fungal infection, 30.7% were cured with intracameral amphotericin injection, while 30.7% needed penetrating keratoplasty. Intracameral amphotericin injection was needed in the presence of large corneal ulcers (>14 mm2), hypopyon, positive fungal culture, use of steroid eye drops, and deep infiltration at initial examination. Large ulcer size (>14 mm2) was the main risk factor for needing penetrating keratoplasty. Of the eyes Candida infection, 66.5% needed evisceration. CONCLUSIONS: Large ulcer size and the isolation of Candida were poor prognostic factors related to the efficacy of intracameral amphotericin injection. |
| Key Words:
Candida;Fungal infection;Intracameral amphotericin injection;Prognostic indicator;Ulcer size |
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