진균 감염 시 전방 내 암포테리신 주입 치료 성적에 관련된 위험 인자 분석

• 영문명: Risk Factors Affecting Efficacy of Intracameral Amphotericin Injection in Deep Keratomycosis
• 발행기관: 대한안과학회
• 저자명: 서제현 위원량 이진학 김미금,Je Hyun Seo, M.D.,, Won-Ryang Wee, M.D., Ph.D.,, Jin Hak Lee, M.D. Ph.D.,, Mee Kum Kim, M.D. Ph.D.,
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume48,number9, 1202~1211쪽, 전체 10쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2007.09.30

영문 초록

Purpose: To investigate the clinical efficacy of intracameral amphotericin injection and to evaluate risk factors affecting primary treatment success in fungal infection invading the anterior segment of the eye. Methods: Twenty-six eyes of 26 patients diagnosed with fungal infection in the anterior segment were studied. The initial treatment regimen was a topical 0.15% amphotericin application and itraconazole oral administration after culture. Amphotericin (5 ug/0.1 ml, 0.1 cc) was repeatedly injected intracamerally when the infection intensified. Penetrating keratoplasty was conducted for eyes unresponsive to intracameral amphotericin injection. The relative risk ratios of ulcer size, infiltration depth, culture positivity, and hypopyon were compared in each treatment group to evaluate the treatment response. Results: Of patients with fungal infection, 30.7% were cured with intracameral amphotericin injection, while 30.7% needed penetrating keratoplasty. Intracameral amphotericin injection was needed in the presence of large corneal ulcers (>14 mm2), hypopyon, positive fungal culture, use of steroid eye drops, and deep infiltration at initial examination. Large ulcer size (>14 mm2) was the main risk factor for needing penetrating keratoplasty. Of the eyes Candida infection, 66.5% needed evisceration. Conclusions: Large ulcer size and the isolation of Candida were poor prognostic factors related to the efficacy of intracameral amphotericin injection.

키워드

Candida, Fungal infection, Intracameral amphotericin injection, Prognostic indicator, Ulcer size