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Category: Volume 08 Issue 07 July 2020
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Title: To Study the Comparison of Therapeutic Effect of Topical Intrastromal and Intracameral Voriconazole in Patients of Fungal Corneal Ulcer

Authors: Swapnil Singh, Dr Lokesh Kumar Singh (M.S), Dr Prof. Sandeep Mithal (M.S.), Dr Prof. Alka Gupta (M.S.)

 DOI: https://dx.doi.org/10.18535/jmscr/v8i7.102

Abstract

Introduction

Diseases of cornea are a major cause of blindness, second only to cataract resulting in more than 1.5 million new cases of vision loss annually. In India, it is estimated that there are approximately 6.8 million people who have vision less than 6/60 in atleast one eye due to corneal diseases; of these, about a million have bilateral involvement.(1,2)

The burden of corneal disease in our country is reflected by the fact that 90% of the global cases of ocular trauma and corneal ulceration leading to corneal blindness occur in developing countries. (5)

Treatable or avoidable blindness can be tackled by an effective and accessible health care service delivery network. In cases of corneal ulceration sight can be restored with timely and prompt management.

Fungal Keratitis

Fungal keratitis was described by Leber in 1879. It can be caused by several species of fungi and also accounts for nearly 50% of all cases of infectious keratitis in developing countries and tropical regions. (6,7) 

References

  1. Garg P, Krishna PV, Stratis AK, Gopinathan U. The value of corneal transplantation in reducing blindness. Eye (Lond) 2005;19:1106-14.
  2. Causes of blindness and visual impairment. Available from: http://www.who.int/blindness/causes/en. Dandona R, Dandona L. Corneal blindness in southern Indian population:Need for health promotion strategies.Br J Ophthalmol. 2003;87:133-41. 
  3. National Programme for Control of Blindness. Available from: http://pbhealth.gov.in/pdf/Blindness.pdf. Whitcher JP, Srinivasan M, Upadhyay MP. Corneal blindness:  A global perspective. Bull World Health Organ. 2001;79:214-21
  4. Ou J. I. and Acharya N. R. Epidemiology and treatment of fungal corneal ulcers,‖ International Ophthalmology Clinics 2007;47(3):7-16
  5. Gopinathan U. , Sharma S. ,Garg P. , and Rao G. ― Review of epidemiological features , microbiological diagnosis and treatment outcome of microbial keratitis: experience of over a decade,‖ Indian Journal of Ophthalmology 2009; 57(4)273-9
  6. Gopinathan U , Garg P, Fernandes M , Sharma S , Athmanathan S, Rao GN. The epidemiological features and laboratory results of fungal keratitis: A 10-year review at a referral eye care center in South India. Cornea. 2002; 21(6):555-559.
  7. Alfonso EC GA, Miller D. Fungal keratitis. In: Krachmer JH, Mannis MJ, Holland EJ, editors. Cornea: fundamentals, diagnosis and management.3rd New York: Mosby Elsevier; 2011
  8. Gao H, Pennesi M, Shah K, Qiao X, Hariprasad SM Ann Ophthalmol 1975;7(4):537-9
  9. Kalaiselvi G , Narayana S    , Krishnan T, Sengupta S Br J Ophthalmol. 2015 Feb;99(2):195-8
  10. Johnson LB, Kauffman CA. Voriconazole: A New Triazole Antifungal Agent. Clinical Infectious Diseases 2003; 36:630–7.
  11. Bruton LL, Chabner BA, Knollomann BC. Goodman and Gilman’s The pharmacological basis of therapeutics. Mc Graw hill publication; 2011. Antifungal Agents;pp. 1571-92.
  12. Jurkunas U, Langston D, Colby K. Use of voriconazole in the treatment of fungal keratitis. Int Ophthalmol Clin 2007; 47:47– 59.
  13. Leveque D, Nivoix Y, Jehl F, Herbrecht R. Clinical pharmacokinetics of voriconazole. Int J Antimicrob Agents 2006; 27:274–84.
  14. Marangon F, Miller D, Giaconi J, Alfonso E. In vitro investigation of voriconazole susceptibility for keratitis and endophthalmitis fungal pathogens. Am J Ophthalmol 2004; 137:820– 25.
  15. Hariprasad SM, Mieler WF, Holz E. Determination of vitreous, aqueous, and plasma concentration of orally administered voriconazole in humans. Arch Ophthalmol 2004; 122:42–7.
  16. Lau D, Fedinands M, Leung Ll. Penetration of voriconazole, 1%, eyedrops into human aqueous humor: A prospective open-label study. Arch Ophthalmol 2008; 126:343–46.
  17. Vemulakonda GA, Hariprasad SM, Mieler WF, Prince RA, Shah GK, Van Gelder RN. Aqueous and vitreous concentrations following topical administration of 1% voriconazole in humans. Arch Ophthalmol 2008; 126:18–22.
  18. Al-Badriyeh D, Leung L, Roydhouse T. Prospective open-label study of the administration of two-percent voriconazole eye drops. Antimicrob Agents Chemother 2009; 53:3153–55.
  19. Lau D, Leung L, Fedinands M, et al. Penetration of 1% voriconazole eye drops into human vitreous humour – a prospective, open-label study. Clin Experiment Ophthalmol 2009; 37:197–200.
  20. Klont R, Eggink C, Rijs A, Wesseling P, Verweij P. Successful treatment of Fusarium keratitis with cornea transplantation and topical and systemic voriconazole. Clin Infect Dis 2005; 40:110–2.
  21. Thiel MA, Zinkernagel AS, Burhenne J, Kaufmann C, Haefeli WE. Voriconazole concentration in human aqueous humor and plasma during topical or combined topical and systemic administration for fungal keratitis. Antimicrob Agents Chemother 2007; 51:239–44.
  22. Al-Badriyeh D, Li J, Stewart K. Stability of extemporaneously prepared voriconazole ophthalmic solution. Am J Health Syst Pharm 2009; 66:1478–83.
  23. Dupuis A, Tournier N, Le Moal G, Venisse N. Preparation and stability of voriconazole eye drop solution. Antimicrob Agents Chemother 2009; 53:798–99
  24. fda.gov[Internet]. New York: Roerig division of Pfizer, Inc.;  [Revised June 2010; cited             Dec2015]. Available   from https://www.accessdata.fda.gov/drugsatfda_ docs/.../021266s032lbl.pdf 
  25. Bhadange Y, Shah B , Takkar B, Sinha R. Review of Doses of Important Drugs in Ophthalmology . Dos Times 2011; 21:23-27. Srinivasan M. Fungal keratitis. Curr Opin Ophthalmol 2004; 15: 321–7.
  26. Cuero RG. Ecological distribution of Fusarium solani and its opportunistic action related to mycotic keratitis in Cali, Colombia. J Clin Microbiol 1980; 12:455–461.
  27. com/voriconazoleeyedrops_cp.asp[Internet]. Madurai: Aurolabs,Inc;[cited jan 2016]. Available from: https://www.google.co.in/url?sa=t&rct=j&q=&esrc=s&so  urce=web&cd=1&ved=0ahUKEwjKP_XxtTKAhXCGKYKHThLBh4QFggcMAA&url=http%3A%2F%2Fwww.aurolab.com%2Fvoriconazoleeyedrops_cp.asp&usg=AFQjCNH2e5cIJ 682faLuJU_RxbrFZHEgXA
  28. Al-Badriyeh D, Leung L, Davies GE, Stewart K, Kong D. Successful salvage treatment of Scedosporium apiospermum keratitis with topical voriconazole after failure of natamycin. Ann Pharmacother 2009; 43:1139–42.
  29. Al-Badriyeh D, Leung L, Davies GE, Stewart K, Kong D. Successful use of topical voriconazole 1% alone as first-line antifungal therapy against Candida albicans keratitis. Ann Pharmacother 2009; 43:2103– 2107.
  30. Prajna NV, Krishnan T, Mascarenhas J, Rajaraman R, Prajna L, Srinivasan M, et al. The mycotic ulcer treatment trial: a randomized trial comparing natamycin vs voriconazole. JAMA ophthalmol 2013; 131:422-9.
  31. Sharma S , Das S, Virdi A, Fernandes M, Sahu SK, Koday NK, et al. Re-appraisal of topical 1% voriconazole and 5% natamycin in the treatment of fungal keratitis in a randomised trial. Br J Ophthalmol 2015; 99:1190-5.
  32. Sharma N, Agarwal P, Sinha R, Titiyal JS, Velpandian T, Vajpayee RB. Evaluation of intrastromal voriconazole injection in recalcitrant deep fungal keratitis: case series. Bjo phthalmol 2011; 95:1735-7.
  33. Kalaiselvi G, Narayana S, Krishnan T, Sengupta S. Intrastromal voriconazole for deep recalcitrant fungal keratitis: a case series Bjophthalmol 2015; 99:195-8.
  34. Bunya VY, Hammersmith KM, Rapuano CJ, Ayres BD, Cohen EJ. Topical and oral voriconazole in the treatment of fungal keratitis. Am J Ophthalmol 2007; 143:151-3. 
  35. Shen YC, Wang CY, Tsai HY, Lee HN. Intracameral voriconazole injection in the treatment of fungal endophthalmitis resulting from keratitis. Am J Ophthalmol 2010; 149:916-21.
  36. Yanoff M,Duker SJ. Ophthalmology. Elsevier Inc;2009. Parasitic keratitis;pp.274-79. Bang S, Edell E, Eghrari AO, Gottsch JD. Treatment with voriconazole in 3 eyes with resistant Acanthamoeba keratitis. Am J Ophthalmol 2010; 149:66-9.

Corresponding Author

Swapnil Singh

Junior Resident 3, Upgraded Department of Ophthalmology, LLRMC, Meerut, U.P., INDIA - 250004