Evaluation of Intracameral Amphotericin B in the Management of Fungal Keratitis: Randomized Controlled Trial.

PURPOSE: To evaluate the efficacy and safety of intracameral amphotericin B (ICAMB) in the management of fungal keratitis. METHODS: In total, 45 eyes with smear-confirmed fungal keratitis with hypopyon were randomized into three treatment groups: Group I (topical antifungal treatment + oral antifungal); Group II (topical antifungal treatment + ICAMB + oral antifungal); and Group III (topical antifungal treatment + drainage of hypopyon + ICAMB + oral antifungal). The main outcome measures were treatment success rate, time to heal, visual acuity gain, and presence of complications. RESULTS: There were no differences in the treatment success rates (p = 0.66), time to healing (p = 0.18), or mean final visual acuity (logMAR) (p = 0.8) between the three groups. The major complication observed was increased incidence of cataract in group III (40%), though it was statistically insignificant. CONCLUSIONS: ICAMB does not offer any benefit over topical antifungal therapy when performed alone or associated with drainage of hypopyon.

Utility of random amplification of polymorphic DNA assay and BOX-A PCR in molecular characterization of Streptococcus pneumoniae isolates recovered from various ophthalmic infections.

BACKGROUND AND OBJECTIVES: Studies emphasizing the genotype distribution among ophthalmic isolates of Streptococcus pneumoniae are scarce. There is no conclusive information on genetic relatedness of the ophthalmic isolates with the commensal and systemic isolates of S. pneumoniae. METHODS: To find out the relatedness between the ophthalmic, invasive and commensal isolates of S. pneumoniae, genotyping was carried out by using RAPD and BOX-A PCR assays. The serotyping was carried out by a rapid co-agglutination method using 12-pooled S. pneumoniae antisera. RESULTS: Topological relationship was identified in order of similarity, and phylogenetic tree was drawn employing sequential clustering alogarithm by UPGMA linkage analysis. The 61 isolates were distributed in 17 RAPD types, 11 BOX-A types and 21 serotypes. CONCLUSIONS: Both genotyping techniques were useful in terms of intraspecies genomic variation in S. pneumoniae. BOX-A PCR typing was found to be slightly superior to RAPD analysis in terms of reproducibility and standardization. No specific S. pneumoniae serotype or genotype was found to have special predilection to cause ophthalmic infections.