Abstract
Purpose: :
The cytotoxicity of conventional amphotericin B (Fungizone) has limited its use of subconjunctival administration. However, the toxicity is not due to the main component of amphotericin B, but more likely attributable to the addition of deoxycholate added as emulsifying reagent. This study was designed to compare the ocular toxicity of liposomal formulation of amphotericin B without deoxycholate with Fungizone.
Methods: :
Male white rabbits were randomly assigned to three groups and received subconjunctival injection of Fungizone (containing 5mg of amphotericin B and 4.1 mg of sodium deoxycholate), deoxycholate (4.1mg), and liposomal formulation of amphotericin B (containing 5mg of amphotericin B), respectively. Twenty–four hours after the injection, slit–lamp examination and histopathological examination were done to evaluate the ocular toxicities of these agents.
Results: :
Rabbits treated with subconjunctival injection of Fungizone or deoxycholate showed remarkable palpebral edema, conjunctival injection, chemosis and, corneal edema. Histopathologically, necrosis of corneal and scleral stroma, corneal epithelial erosion, and severe infiltration of inflammatory cells were observed in Fungizone or deoxycholate groups. These toxic effects seldom occurred in the liposomal formulation of amphotericin B group.
Conclusions: :
The ocular toxicity of Fungizone attribute mainly to deoxycholate but not amphotericin B. The usage of subconjunctival administration of liposomal formulation of amphotericin B would be a feasible option for the treatment of keratomycosis.
Keywords: fungal disease • keratitis • drug toxicity/drug effects