国际眼科杂志2010，Vol.10Issue(11)：2054-2057,4.DOI:10.3969/j.issn.1672-5123.2010.11.003
两性霉素B角膜基质内注射成功治疗真菌性角膜炎1例
Successful treatment of a refractory stromal fungal keratitis by intrastromal injection of amphotericin B
Yanti Muslikhan 1Nor Sharina Yusuf 1Khairy Shamel Sonny Teo 1Azhany Y aakob 1Mohtar Ibrahim1
作者信息
- 1. 马来西亚吉兰丹,马来西亚理科大学医学院眼科
- 折叠
摘要
Abstract
AIM: To report a successful intrastromal injection of amphotericin B 5mg/L in a refractory fungal keratitis.METHODS: An interventional case report RESULTS: A 48-year-old lady presented with history of redness of the right eye for one week duration followed by decrease in vision and corneal opacity for two days. There was no histow of trauma or foreign body. Examination revealed visual acuity of 6/16 with pinhole of 6/12 of the right eye. The conjunctiva was injected with minimal eye discharge. There was a full thickness stromal abscess at the paracentral area of the cornea. It was irregular,feathery margin with few satellite lesions. There was no epithelial defect noted. Hypopyon level was also seen.The left eye was normal. A presumptive diagnosis of fungal keratitis was entertained. Despite three weeks of intensive treatment with topical amphotericin B every 2 hours and natamycin every 4 hours and antibiotic cover,the lesion showed no sign of resolution. It grew larger and a new focal lesion of stromal abscess appeared at the 12 o'clock position. We decided to proceed with an intrastromal injection of amphotericin B 5mg/L in lieu of therapeutic penetrating keratoplasty. The size of the ulcer was substantially reduced with total disappearance of hypopyon. There was no ocular toxicity observed following the intervention. Patient regained her normal visual acuity of 6/6 after 2 months of intervention.CONCLUSION: An intrastromal injection of amphotericin B 5mg/L provides an alternative method of treating refractory fungal keratitis. It is also shown to be an effective and safe procedure with promising results.关键词
真菌性角膜炎/角膜基质注射/两性霉素BKey words
fungal keratitis/intrastromal injection/amphotericin B分类
医药卫生引用本文复制引用
Yanti Muslikhan,Nor Sharina Yusuf,Khairy Shamel Sonny Teo,Azhany Y aakob,Mohtar Ibrahim..两性霉素B角膜基质内注射成功治疗真菌性角膜炎1例[J].国际眼科杂志,2010,10(11):2054-2057,4.
