Abstract
Purpose :
To study the effects of topical fumagillin compared to fluconazole in microsporidal keratitis.
Methods :
A retrospective, comparative observational study of 10 immunocomptent patients with microsporidal keratitis, Both keratoconjunctivitis and stromal keratitis forms were included. All patients had corneal or conjunctival scrapings. Five patients were treated with fumagillin 2mg/ml eye drops and five patients were treated with topical fluconazole 2mg/ml. The outcome measures included symptoms, final best corrected visual acuity and resolution of keratitis.
Results :
There were 10 patients with microspordial keratitis comprising 6 male and 4 female patients. The mean age was 39 years (range: 19–60 years). All patients showed improvement of symptoms of photophobia and ocular pain. Nine out of 10 patients showed complete resolution of their keratitis. One patient had corneal haze that was treated with phototherapeutic keratectomy (PTK). Four (80%) out of five patients treated with topical fumagillin showed improvement in visual acuity to 20/20 compared to three (60%) out of 5 patients treated with topical fluconazole(p=0.49). The mean time for resolution of keratitis was 23.2 days (2 to 30 days) in the fumagillin group and 46.2 days (7 to 150 days) in the fluconazole group. One case of recurrence was noted in the fumagillin group and showed complete resolution with higher concentration of fumagillin 3mg/ml.
Conclusions :
Topical fumagillin is as effective as topical fluconazole in the treatment of microsporidal keratiti. The difference in clinical response to fumagillin and fluconazole was not statistically significant (p=0.49). However, the time of resolution of keratitis was shorter with fumagillin.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.