ABSTRACT
BACKGROUND AND OBJECTIVES: Transpupillary thermotherapy (TTT) with indocyanine green (ICG) dye enhancement (TTT+) and TTT alone were compared for safety and effectiveness as a treatment of occult subfoveal choroidal neovascularization in age-related macular degeneration. PATIENTS AND METHODS: Twenty-one patients were randomized to receive TTT (12 eyes) or TTT+ (9 eyes) and observed for at least 6 months. ETDRS visual acuity and fluorescein and ICG angiography were obtained every 3 months. RESULTS: The median initial visual acuity was 20/80 in the TTT group and 20/100 in the TTT+ group. At 6 months, loss of less than 3 lines of visual acuity was present in 7 of 12 eyes (58%) in the TTT group and 5 of 9 eyes (56%) in the TTT+ group. At the final examination, there was no active choroidal neovascularization exudation in 6 of 12 eyes (50%) in the TTT group and 5 of 9 eyes (56%) in the TTT+ group. The median final visual acuity was 20/125 in the TTT group and 20/160 in the TTT+ group. Ocular or systemic complications were not encountered in either group. CONCLUSION: TTT with ICG dye enhancement was as safe and effective as TTT alone in this study. However, modifications of treatment protocol would be needed to see whether there is any advantage to using ICG dye enhancement.
Subject(s)
Choroidal Neovascularization/therapy , Coloring Agents/administration & dosage , Hyperthermia, Induced/methods , Indocyanine Green/administration & dosage , Macular Degeneration/complications , Aged , Aged, 80 and over , Choroidal Neovascularization/etiology , Fluorescein Angiography , Fovea Centralis , Humans , Middle Aged , Pupil , Treatment Outcome , Visual Acuity/physiologySubject(s)
Diabetic Retinopathy , Retinal Neovascularization , Diabetic Retinopathy/complications , Diabetic Retinopathy/diagnosis , Diabetic Retinopathy/surgery , Humans , Laser Coagulation , Retinal Neovascularization/complications , Retinal Neovascularization/diagnosis , Retinal Neovascularization/surgeryABSTRACT
PURPOSE: To determine the in vitro antifungal activity of voriconazole, a new triazole, compared with other polyene and imidazole antifungal agents against corneal isolates of Scedosporium apiospermum. METHODS: Macro-broth dilution susceptibility testing was performed on five isolates of S. apiospermum obtained from patients with keratomycosis to determine the minimal inhibitory concentrations (MICs) for amphotericin B, natamycin, ketoconazole, itraconazole, and voriconazole. The use of oral voriconazole in the management of a patient with posttraumatic S. apiospermum keratitis is described. RESULTS: S. apiospermum is generally resistant to commonly used topical ophthalmic antifungal agents. The MIC of voriconazole was 0.5 microg/mL, a concentration lower than that of other imidazoles. CONCLUSION: Voriconazole has promising activity against and may prove useful in the management of fungal keratitis.
