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Parker RA, Gabriel KT, Graham KD, Butts BK, Cornelison CT. Antifungal Activity of Select Essential Oils against Candida auris and Their Interactions with Antifungal Drugs. Pathogens 2022; 11:pathogens11080821. [PMID: 35894044 PMCID: PMC9331469 DOI: 10.3390/pathogens11080821] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/24/2022] Open
Abstract
Candida auris is an emerging fungal pathogen that commonly causes nosocomial blood infections in the immunocompromised. Several factors make this pathogen a global threat, including its misidentification as closely related species, its ability to survive for weeks on fomites, and its resistance to commonly prescribed antifungal drugs, sometimes to all three classes of systemic antifungal drugs. These factors demonstrate a need for the development of novel therapeutic approaches to combat this pathogen. In the present study, the antifungal activities of 21 essential oils were tested against C. auris. Several essential oils were observed to inhibit the growth and kill C. auris, Candida lusitaniae, and Saccharomyces cerevisiae when in direct contact and at concentrations considered safe for topical use. The most effective essential oils were those extracted from lemongrass, clove bud, and cinnamon bark. These essential oils also elicited antifungal activity in gaseous form. The efficacies of formulations comprised of these three essential oils in combination with fluconazole, amphotericin B, flucytosine, and micafungin were explored. While synergism was neither observed with cinnamon bark oil nor any of the antifungal drugs, lemongrass oil displayed synergistic, additive, and indifferent interactions with select drugs. Formulations of clove bud oil with amphotericin B resulted in antagonistic interactions but displayed synergistic interactions with fluconazole and flucytosine. These essential oils and their combinations with antifungal drugs may provide useful options for surface disinfection, skin sanitization, and possibly even the treatment of Candida infections.
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Szaliński M, Zgryźniak A, Rubisz I, Gajdzis M, Kaczmarek R, Przeździecka-Dołyk J. Fusarium Keratitis-Review of Current Treatment Possibilities. J Clin Med 2021; 10:jcm10235468. [PMID: 34884170 PMCID: PMC8658515 DOI: 10.3390/jcm10235468] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 12/13/2022] Open
Abstract
In many parts of the world, fungi are the predominant cause of infectious keratitis; among which, Fusarium is the most commonly isolated pathogen. The clinical management of this ophthalmic emergency is challenging. Due to the retardation of the first symptoms from an injury and the inability to differentiate fungal from bacterial infections based on clinical symptoms and difficult microbial diagnostics, proper treatment, in many cases, is postponed. Moreover, therapeutical options of Fusarium keratitis remain limited. This paper summarizes the available treatment modalities of Fusarium keratitis, including antifungals and their routes of administration, antiseptics, and surgical interventions.
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Affiliation(s)
- Marek Szaliński
- Department of Ophthalmology, Wroclaw Medical University, ul. Borowska 213, 50-556 Wrocław, Poland; (M.S.); (M.G.); (R.K.); (J.P.-D.)
- Clinic of Ophthalmology, University Teaching Hospital, ul. Borowska 213, 50-556 Wrocław, Poland
| | - Aleksandra Zgryźniak
- Clinic of Ophthalmology, University Teaching Hospital, ul. Borowska 213, 50-556 Wrocław, Poland
- Correspondence:
| | - Izabela Rubisz
- Okulus Ophthalmology Clinic, ul. Śródmiejska 34, 62-800 Kalisz, Poland;
| | - Małgorzata Gajdzis
- Department of Ophthalmology, Wroclaw Medical University, ul. Borowska 213, 50-556 Wrocław, Poland; (M.S.); (M.G.); (R.K.); (J.P.-D.)
| | - Radosław Kaczmarek
- Department of Ophthalmology, Wroclaw Medical University, ul. Borowska 213, 50-556 Wrocław, Poland; (M.S.); (M.G.); (R.K.); (J.P.-D.)
- Clinic of Ophthalmology, University Teaching Hospital, ul. Borowska 213, 50-556 Wrocław, Poland
| | - Joanna Przeździecka-Dołyk
- Department of Ophthalmology, Wroclaw Medical University, ul. Borowska 213, 50-556 Wrocław, Poland; (M.S.); (M.G.); (R.K.); (J.P.-D.)
- Department of Optics and Photonics, Wroclaw University of Science and Technology, Wyb. Stanisława Wyspiańskiego 27, 50-370 Wrocław, Poland
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Abstract
PURPOSE Voriconazole was shown to inhibit ergosterol synthesis in various acanthamoeba species. The purpose of this study was to evaluate the clinical outcome of treatment with supplemental topical voriconazole in patients with acanthamoeba keratitis (AK). METHODS All patients who had been treated for AK with voriconazole 1% drops in conjunction with topical first-line antiacanthamoeba therapy composed of polyhexamethylene biguanide (PHMB) 0.02% and propamidine isethionate 0.1% (Brolene) between November 2014 and August 2017 at the Department of Ophthalmology, University Medical Center Mainz, were included. The main outcomes were treatment failure and recurrence rate. Secondary outcomes were visual acuity, need for keratoplasty, and presence of adverse reactions. RESULTS Twenty-eight eyes of 28 patients with AK, whose treatment had included topical voriconazole, were identified (12 men, 16 women, mean age: 41.7 ± 16.3 years), and 26 of them could be tracked for at least 3 months after cessation of therapy. Resolution of infection under therapy was seen in all eyes, and only one of 26 (3.85%) had a relapse after the therapy had been stopped. Best-corrected visual acuity improved during therapy. Keratoplasty because of central corneal scarring was scheduled in 5 of 26 patients (19.2%) after the pharmacological therapy had been stopped. Five of 26 patients (19.2%) reported on stinging or burning sensation after application of voriconazole 1% drops. CONCLUSIONS Topical voriconazole 1% combined with first-line therapy composed of polyhexamethylene biguanide 0.02% and propamidine isethionate 0.1% appears to be an effective option with minor side effects for the treatment of AK.
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Toxicity profiles of fixed-combination eye drops for glaucoma therapy using cultivated human corneal epithelial sheets. Jpn J Ophthalmol 2020; 64:304-311. [PMID: 32338324 DOI: 10.1007/s10384-020-00742-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 01/31/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE We aimed to investigate the toxicity of 6 fixed-combination drugs for glaucoma therapy using human corneal epithelial sheets (HCES). STUDY DESIGN Experimental. MATERIALS AND METHODS We used 6 kinds of commercially available fixed-combination drugs: latanoprost/carteolol (LAT/CAR), latanoprost/timolol (LAT/TIM), tafluprost/timolol (TAF/TIM), travoprost/timolol (TRA/TIM), brinzolamide/timolol (BRZ/TIM), and dorzolamide/timolol (DRZ/TIM) including different preservatives. The cell viability and barrier function of the HCES after exposure to the eye drops for 10 or 30 minutes were assessed using the WST-1 assay and transepithelial electrical resistance (TEER) measurements, respectively. The HCES were also evaluated using hematoxylin and eosin (HE) staining and transmission electron microscopy. RESULTS The cell viability significantly decreased in the HCES treated with LAT/TIM or DRZ/TIM after 10 and 30 minutes and in those treated with BRZ/TIM after 30 minutes. The barrier function increased significantly in the HCES treated with LAT/CAR. Histologically, the HCES were damaged after treatment with LAT/TIM, BRZ/TIM, or DRZ/TIM for 30 minutes. Transmission electron microscopy indicated narrow intercellular spaces and multiple intercellular junctions in the HCES treated with LAT/CAR, TAF/TIM, or TRA/TIM. The HCES treated with DRZ/TIM, BRZ/TIM, or LAT/TIM contained cytoplasmic vacuoles and collapsed cellular structures. CONCLUSION Glaucoma fixed-combination eye drops demonstrated a different toxic effect on the cell viability, barrier function, and morphologic changes of HCES.
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Stability of frozen 1% voriconazole eye-drops in both glass and innovative containers. Eur J Pharm Sci 2020; 141:105102. [DOI: 10.1016/j.ejps.2019.105102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/04/2019] [Accepted: 10/07/2019] [Indexed: 11/21/2022]
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Wei A, Wang K, Wang Y, Gong L, Xu J, Shao T. Evaluation of corneal cross-linking as adjuvant therapy for the management of fungal keratitis. Graefes Arch Clin Exp Ophthalmol 2019; 257:1443-1452. [PMID: 31041523 DOI: 10.1007/s00417-019-04314-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 02/27/2019] [Accepted: 04/01/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To evaluate the efficacy of corneal cross-linking (CXL) as adjuvant therapy for the treatment of fungal ulcerative keratitis. METHODS Forty-one patients with fungal ulcerative keratitis were recruited and assigned into two randomized controlled groups. These groups were treated with CXL combined with antifungal medications (CXL-M) or antifungal medications alone (M). The ulcers were assessed by slit-lamp biomicroscopy, slit-lamp images, in vivo confocal microscopy (IVCM), and anterior segment optical coherence tomography (AS-OCT). The patients were followed up before surgery/first visit (FV), 1 day after surgery, 1 and 2 weeks, and 1, 2, 3, 4, 5, and 6 months after surgery/FV. RESULTS In the cured patients, the area of corneal ulcers, the duration of ulcer healing, the time to non-observed fungal hyphae by IVCM, the number of antifungal medications, the frequency of administered medications, and the maximum ulcer depth decreased significantly after CXL (all P < 0.05) compared with the M group. There were no significant differences in either corneal thickness or epithelial thickness of ulcers after healing between 5 and 6 months after surgery in the CXL-M group, while these were increased significantly at 6 months compared with 5 months after FV in the M group (both P < 0.05). CONCLUSIONS In our study, CXL accelerated healing of the fungal ulcers, shortened the treatment duration, and minimized the need for medications and surgery. It appears that CXL is an effective procedure and adjuvant therapy for managing fungal keratitis.
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Affiliation(s)
- Anji Wei
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, School of Shanghai Medicine, Fudan University, 83 Fenyang Road, Shanghai, 20003, China
| | - Kaidi Wang
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, School of Shanghai Medicine, Fudan University, 83 Fenyang Road, Shanghai, 20003, China
| | - Yan Wang
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, School of Shanghai Medicine, Fudan University, 83 Fenyang Road, Shanghai, 20003, China
| | - Lan Gong
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, School of Shanghai Medicine, Fudan University, 83 Fenyang Road, Shanghai, 20003, China
| | - Jianjiang Xu
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, School of Shanghai Medicine, Fudan University, 83 Fenyang Road, Shanghai, 20003, China
| | - Tingting Shao
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, School of Shanghai Medicine, Fudan University, 83 Fenyang Road, Shanghai, 20003, China.
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Kasparova EA, Fedorov AA, Sobkova OI. [Influence of frequent instillations of anti-infective solutions on eye tissues (an experimental study)]. Vestn Oftalmol 2019; 135:160-170. [PMID: 31691655 DOI: 10.17116/oftalma2019135052160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE To investigate the toxic effects of frequent instillations of anti-infective solutions (antibiotic eye drops - 0.3 and 1.4% tobramycin, 0.5% levofloxacin and 0.5% moxifloxacin; antiseptic eye drops - 0.05% pyloxidine and 0.025% chlorhexidine; antifungal drug - 2 mg/ml fluconazole solution) on ocular tissues. MATERIAL AND METHODS The study was conducted on 21 Wistar rats (42 eyes) using method of semi-fine sections. RESULTS The majority of antibiotics and antifungal agents do not cause toxic reactions in rats` eyes when instilled with frequent regimen with the exception of 'fortified' 1.4% tobramycin and pyloxidine solutions, which caused a decrease in corneal endothelial cells density and formation of fibrovascular tissue in the anterior chamber. CONCLUSION Frequent instillations of antimicrobial drug solutions is a safe method for the treatment of purulent corneal ulcers and purulent keratitis. The exceptions were solutions of 'fortified' 1.4% tobramycin and piloxidine (vitabact).
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Affiliation(s)
- E A Kasparova
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - A A Fedorov
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - O I Sobkova
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
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Epithelial defects after penetrating keratoplasty in infectious keratitis: An analysis of characteristics and risk factors. PLoS One 2018; 13:e0208163. [PMID: 30485371 PMCID: PMC6261636 DOI: 10.1371/journal.pone.0208163] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 11/13/2018] [Indexed: 11/19/2022] Open
Abstract
To investigate the clinical characteristics, treatment, risk factors of occurrence and graft transparency of corneal epithelial defects after penetrating keratoplasty in patients with infectious keratitis. 594 patients (594 eyes) with infectious keratitis treated by penetrating keratoplasty at Shandong Eye Institute were reviewed retrospectively between January 2008 and January 2018. We investigated the demographic data, diameter and sources of graft, onset time, location, scope, time of healing and treatment of epithelial defects, as well as other postoperative complications and graft clarity. 114 of the 594 grafts (19.2%) that developed epithelial defects were included in the epithelial defects group, while the other 480 patients were classified in the non-defect group. The mean age of patients with epithelial defects was statistically greater than that of patients without epithelial defects (P = 0.006). The epithelial defects group accounted for a larger proportion of male patients (P<0.001). The proportion of patients with a graft diameter >9mm in the epithelial defect group (29.8%) was more than that in the non-defects group (16.3%) (P = 0.001). The incidence of epithelial defects significantly differed among the pathogenic causes of infectious keratitis (P = 0.002). The incidence of graft infection (21.1%, 9.2%, respectively, P<0.001) and graft dysfunction (7.9%, 2.5%, respectively, P = 0.012) in the epithelial defect group was higher than in the non-defects group. Multivariate logistic regression revealed that male sex (P = 0.001), age ≥ 60 years (P = 0.024), graft diameter >9mm (P = 0.001), bacterial (P = 0.039) and herpes simplex keratitis (P = 0.008), rheumatism (P = 0.031) and cancer treated with chemo- or radiotherapy (P = 0.032) were independent risk factors for epithelial defects. Graft clarity after epithelial defects were significantly differed between fungal and viral infections (P<0.001). We found that being an elderly male patient, a graft diameter >9 mm, bacterial and viral keratitis and systemic diseases (including rheumatism and cancer treated with chemo- or radiotherapy) were independent risk factors for postoperative epithelial defects.
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Arikan G, Karatas E, Lebe B, Ayhan Z, Utine CA, Kutsoylu OE, Gunenc U, Yilmaz O. Topically applied 1% voriconazole induces dysplastic changes on the ocular surface: animal study. Cutan Ocul Toxicol 2018; 37:328-331. [PMID: 29633868 DOI: 10.1080/15569527.2018.1463237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To identify the risk of inducing ocular surface dysplasia following topical administration of 1% voriconazole eye drop. METHODS Fourteen noninflamed healthy eyes of 14 white adult New Zealand rabbits were included in the study. The rabbits were randomly divided into two groups comprised of 7 rabbits each. Group 1 received topical 1% voriconazole and Group 2 received topical saline as the control group. In all animals, right eye was selected for the study. In Group 1 (Voriconazole Group), single drop of voriconazole was instilled every 10 min consecutively for 17 times a day for 60 days. In Group 2 (Control Group), single drop of saline was instilled every 10 min consecutively for 17 times a day for 60 days. At two months, animals were sacrificed and study eyes were enucleated with the eyelids. The specimens were stained with hematoxylin-eosin and histopathologic changes in cornea, bulbar and palpebral conjunctiva were evaluated under light microscope. RESULTS There were no macroscopically visible lesions on the ocular surface of any rabbits. Histopathological evaluation showed mild to moderate dysplasia localized mainly in the limbus and extending to the adjacent cornea and bulbar conjunctiva in all rabbits in Voriconazole Group. Severe dysplasia or carcinoma in situ was not observed. In the Control Group, dysplasia was not observed, at all. CONCLUSION This animal study provides a possible relationship between topically administered 1% voriconazole and ocular surface dysplasia. We recommend ophthalmologists to be aware of the risk of ocular surface dysplasia in patients received voriconazole eye drop.
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Affiliation(s)
- Gul Arikan
- a Department of Ophthalmology , Dokuz Eylul University School of Medicine , Izmir , Turkey
| | - Ezgi Karatas
- a Department of Ophthalmology , Dokuz Eylul University School of Medicine , Izmir , Turkey
| | - Banu Lebe
- b Department of Pathology , Dokuz Eylul University School of Medicine , Izmir , Turkey
| | - Ziya Ayhan
- a Department of Ophthalmology , Dokuz Eylul University School of Medicine , Izmir , Turkey
| | - Canan Asli Utine
- a Department of Ophthalmology , Dokuz Eylul University School of Medicine , Izmir , Turkey
| | - Oya Eren Kutsoylu
- c Department of Infectious Diseases and Clinical Microbiology , Dokuz Eylul University School of Medicine , Izmir , Turkey
| | - Uzeyir Gunenc
- a Department of Ophthalmology , Dokuz Eylul University School of Medicine , Izmir , Turkey
| | - Osman Yilmaz
- d Department of Laboratory Animals Science , Dokuz Eylul University, Institute of Health Science , Izmir , Turkey
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Ocular surface squamous neoplasia in a setting of fungal keratitis: a rare co-occurrence. Int Ophthalmol 2018; 39:717-720. [DOI: 10.1007/s10792-018-0864-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 02/03/2018] [Indexed: 10/18/2022]
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Cho YK, Shin EY, Uehara H, Ambati B. Effect of itraconazole on the cornea in a murine suture model and penetrating keratoplasty model. Int J Ophthalmol 2017; 10:1647-1654. [PMID: 29181306 DOI: 10.18240/ijo.2017.11.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 08/24/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the anti-(lymph)angiogenic and/or anti-inflammatory effect of itraconazole in a corneal suture model and penetrating keratoplasty (PK) model. METHODS Graft survival, corneal neovascularization, and corneal lymphangiogenesis were compared among itraconazole, amphotericin B, dexamethasone, phosphate buffered saline (PBS) and surgery-only groups following subconjunctival injection in mice that underwent PK and corneal suture. Immunohistochemical staining and analysis were performed in each group. Real-time polymerase chain reaction (RT-PCR) was performed to quantify the expression of inflammatory cytokines (TNF-alpha, IL-6) and vascular endothelial growth factor (VEGF)-A, VEGF-C, VEGFR-2, and VEGFR-3. RESULTS In the suture model, the itraconazole group showed less angiogenesis, less lymphangiogenesis, and less inflammatory infiltration than the PBS group (all P<0.05). The itraconazole group showed reduced expression of VEGF-A, VEGFR-2, TNF-alpha, IL-6 than the PBS group (all P<0.05). In PK model, the two-month graft survival rate was 28.57% in itraconazole group, 62.50% in dexamethasone group, 12.50% in PBS group, 0 in amphotericin B group and 0 in surgery-only group. Graft survival in the itraconazole group was higher than that in the amphotericin, PBS and surgery-only group (P=0.057, 0.096, 0.012, respectively). The itraconazole group showed less total angiogenesis and lymphangiogenesis than PBS group (all P<0.05). CONCLUSION Itraconazole decrease neovascularization, lymphangiogenesis, and inflammation in both a corneal suture model and PK model. Itraconazole has anti-(lymph)-angiogenic and anti-inflammatory effects in addition to its intrinsic antifungal effect and is therefore an alternative treatment option in cases where steroids cannot be used.
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Affiliation(s)
- Yang Kyung Cho
- Department of Ophthalmology, St.Vincent's Hospital, College of Medicine, the Catholic University of Korea, 93 Ji-Dong, Paldal-Gu, Suwon, Gyeonggi-Do 16247, Korea
| | - Eun Young Shin
- Research Institute of Medical Science, St.Vincent's Hospital, the Catholic University of Korea, 93 Ji-Dong, Paldal-Gu, Suwon, Gyeonggi-Do 16247, Korea
| | - Hironori Uehara
- Department of Ophthalmology, School of Medicine, University of Utah, Salt Lake City, Utah 84132, USA
| | - Balamurali Ambati
- Department of Ophthalmology, School of Medicine, University of Utah, Salt Lake City, Utah 84132, USA
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High Permeability and Intercellular Space Widening With Brimonidine Tartrate Eye Drops in Cultured Stratified Human Corneal Epithelial Sheets. Cornea 2017; 37:242-247. [PMID: 29135708 DOI: 10.1097/ico.0000000000001450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the toxicity of topical glaucoma medications using cultured stratified human corneal epithelial sheets (HCES). METHODS HCES were exposed for 30 minutes to the following glaucoma medications: 0.1% brimonidine with sodium chlorite as the preservative, 0.005% latanoprost with 0.02% benzalkonium chloride (BAC) as the preservative, and 0.5% timolol with 0.005% BAC as the preservative. Then, cell viability and barrier function were tested by the WST-1 assay and carboxyfluorescein permeability assay, respectively. After exposure to glaucoma medications, HCES were evaluated by hematoxylin and eosin staining, periodic acid-Schiff staining, scanning electron microscopy, and transmission electron microscopy. RESULTS HCES exposed to brimonidine showed higher viability and better preservation of cell morphology and microvilli compared with cell sheets exposed to latanoprost or timolol. The carboxyfluorescein permeability assay demonstrated that the barrier function was preserved after HCES were exposed to timolol, but not after exposure to brimonidine or latanoprost. Transmission electron microscopy revealed widening of intercellular junctions with prominent deposits of glycogen or mucopolysaccharide (periodic acid-Schiff positive) after exposure of HCES to brimonidine. CONCLUSIONS The toxicity of 0.1% brimonidine containing sodium chlorite for HCES was lower than that of ophthalmic preparations containing BAC. Reduction of the barrier function occurred after HCES were exposed to brimonidine because of widening of intercellular junctions.
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Li PH, Chen CC, Liou SW. Candida parapsilosis keratitis treated successfully with topical and oral fluconazole. Taiwan J Ophthalmol 2016; 6:155-157. [PMID: 29018733 PMCID: PMC5525611 DOI: 10.1016/j.tjo.2016.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 04/08/2016] [Accepted: 04/14/2016] [Indexed: 11/25/2022] Open
Abstract
A 73-year-old male patient presented with ocular pain, redness, and blurred vision in the left eye, which had been ongoing for more than 2 months. An oval-shaped paracentral corneal ulcer with stromal infiltration and a mild anterior chamber reaction were found. Despite treatment with empiric antibiotics, the lesion progressed and corneal thinning in the middle area was noted. The culture yielded Candida parapsilosis. We therefore prescribed topical 0.2% fluconazole (FCZ) in combination with oral FCZ as an antifungal treatment, following which the stromal infiltration gradually subsided. Complete epithelial-ization was noted on the 8th day after initiating FCZ therapy. There was no recurrent disease in the subsequent 2 years. Our case demonstrates that topical FCZ 0.2% in combination with oral FCZ can successfully treat C. parapsilosis keratitis and result in a good visual outcome.
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Affiliation(s)
- Pei-Hsuan Li
- Department of Ophthalmology, Taipei City Hospital Renai Branch, Taipei, Taiwan
| | - Chun-Chen Chen
- Department of Ophthalmology, Taipei City Hospital Renai Branch, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shiow-Wen Liou
- Department of Ophthalmology, Taipei City Hospital Renai Branch, Taipei, Taiwan.,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.,Taipei Medical University, Taipei, Taiwan
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