Intracorneal injection of amphothericin B for recurrent fungal keratitis and endophthalmitis

Arch Ophthalmol. 2005 Dec;123(12):1721-3. doi: 10.1001/archopht.123.12.1721.

Abstract

Penetrating keratoplasty carries an infectious risk. Its requirement for topical corticosteroid therapy facilitates fungal growth with resulting keratitis. Although progression of fungal keratitis to intraocular infection is uncommon, endophthalmitis resulting from keratitis usually has a poor visual prognosis. Fungal infection under these circumstances remains a diagnostic and therapeutic challenge. We report a complicated case of recurrent fungal keratitis with endophthalmitis following a contaminated penetrating keratoplasty that ultimately was controlled with a new treatment modality. Intrastromal corneal injections combined with intravitreal injection of amphotericin B led to the eradication of the corneal fungal plaques and the intraocular infection. Intrastromal corneal injections of amphotericin B may offer a less invasive, in-office alternative to repeat penetrating keratoplasty.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Amphotericin B / therapeutic use*
  • Antifungal Agents / therapeutic use
  • Candida glabrata / isolation & purification*
  • Candidiasis / drug therapy*
  • Candidiasis / microbiology
  • Candidiasis / transmission
  • Corneal Stroma / drug effects*
  • Corneal Stroma / microbiology
  • Corneal Ulcer / drug therapy*
  • Corneal Ulcer / microbiology
  • Corneal Ulcer / pathology
  • Disease Transmission, Infectious
  • Endophthalmitis / drug therapy*
  • Endophthalmitis / microbiology
  • Endophthalmitis / pathology
  • Eye Infections, Fungal / drug therapy*
  • Eye Infections, Fungal / microbiology
  • Eye Infections, Fungal / transmission
  • Female
  • Humans
  • Injections
  • Keratoplasty, Penetrating
  • Recurrence
  • Tissue Donors
  • Vitreous Body / microbiology

Substances

  • Antifungal Agents
  • Amphotericin B