A comparative assessment of voriconazole vs natamycin in treatment of mycotic corneal ulcer
Journal Title: Medpulse International Journal of Ophthalmology - Year 2017, Vol 3, Issue 1
Abstract
Background: Mycotic corneal ulcer is endemic in tropical regions accounting for as many as half of corneal ulcers. Management of fungal keratitis requires timely diagnosis of the infection and administration of appropriate antifungal therapy. Antifungal agents are still the major therapeutic options in fungal keratitis, whereby success depends on the agent’s ability to penetrate into the aqueous and achieve therapeutic levels. Aims and Objectives: To evaluate the efficacy and safety of topical ophthalmic solution Voriconazole (1%) and Natamycin (5%) ophthalmic suspension in treatment of mycotic corneal ulcer and its comparison. Materials and Method: Study was carried out in the Department of Ophthalmology, M.K.C.G. Medical College and Hospital, Berhampur, Odisha from October 2014 to september 2016. Study included 40 patients with fungal kertitis at M.K.C.G. Hospital in India who were randomized to receive either topical natamycin or topical voriconazole. The mean size of corneal ulcer,depth of infiltrate and visual acuity were comparable in both groups. Results: The improvement in signs like size of corneal ulcer, depth of infiltrate and visual acuity was 60%, 80%, 75% in natamycin group and 50%, 60%, 55% in voriconazole group at 1week follow-up. Conclusion: Topical 1% voriconazole was found to be safe and effective drug in primary management of fungal keratitis, its efficacy matching conventional topical 5% natamycin. There was no extra advantage of using topical 1% voriconazole over topical natamycin 5% as primary treatment in fungal keratitis and can be used as a reserve drug in case of failure of conventional therapy. Hence, the results of our study showed efficacy of both natamycin and voriconazole in treatment of fungal keratitis with no added advantage over natamycin
Authors and Affiliations
Namita Bariha, B N R Subudhi
Keywords
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