Che Mahiran, Che Daud
(2008)
An experimental study on intrastromal
injection of amphotericin bin fusarium
solan/keratitis in rabbits.
Masters thesis, Universiti Sains Malaysia.
Abstract
To compare the effectiveness between intrastromal injection of amphotericin B
0.15% (1.5mg/ml) and intrastromal injection of amphotericin B 0.0005% (5Jlg/ml)
and the safety of intrastromal injection Amphotericin B 0.0005% in Fusarium so/ani
keratitis in rabbits.
Methodology:
Fungal keratitis was induced with a standardized inoculum of Fusarium so/ani
placed on the debrided cornea into the right eye of 18 New Zealand white rabbits.
Rabbits in Group A (n=6) were treated with topical 0.1 5% amphotericin B every
hourly for 12 hours daily (control), while rabbits in Group B (n=6) were treated with
intrastromal injection 0.15 % (1.5mg/ml) of amphotericin B and Group C rabbits
(n=6) were treated with intrastromal injection 0.0005% (5J.Lg/ml) of amphotericin B.
The intrastromal injection was given at day 3, 6, 9 and 11. Serial clinical
examination was conducted at day 3, 6, 9, 11 and 14 to look at the changes in the
size of the epithelial defect, the depth of the ulcer, stromal infiltration, hypopyon and
the presence of satellite lesion. The infected eyes were enucleated on the day 14 and
sent for histopathology evaluation.
Results:
The intrastromal injection of amphotericin B 0.0005% injection (group C) was found
to be effective compared to intrastromal injection amphotericin B 0.15% (p<O.OO 1)
in treating Fusarium keratitis in rabbits. There was statistical significant difference in
the size of epithelial defect (p=0.02) and satellite lesion (p=0.02) for the rabbits
treated with intrastromal injection of amphotericin B 0.0005% compared to the
intrastromal injection of amphotericin B 0.1 5%. Histopathological examination also
revealed absence of fungal load, the depth of ulcer limited to anterior two third,
moderate inflammatory responses and mild granulation tissue in the group treated
with intrastromal injection amphotericin B 0.0005%. These histopathological
findings were consistent with serial clinical observation. There was no evidence of
corneal decompensation, severe punctate keratopathy and or corneal melting in the
group treated with intrastromal injection amphotericin B 0.0005%.
Conclusion:
Intrastromal injection of amphotericin B 0.0005% (5J.1g/ml) was found to be effective
and safe in treating Fusarium so/ani keratitis. Thus, after undergoing clinical trial it
can be applied to the patient whose refractory to conventional therapy and can reduce
the cost and shorten the hospital stay.
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