Hiraoka Takahiro, Kaji Yuichi, Wakabayashi Taketoshi, Nanbu Patricia N, Okamoto Fumiki, Oshika Tetsuro
Department of Ophthalmology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
Cornea. 2007 Apr;26(3):336-42. doi: 10.1097/ICO.0b013e31802cd8a8.
To evaluate the efficacy of subconjunctival injection of micafungin in the treatment of experimental Candida albicans keratitis in rabbits compared with fluconazole.
In 1 eye of 24 New Zealand white rabbits, C. albicans (5 x 10 yeast cells) was inoculated in the corneal stroma. The animals were randomly assigned to 3 groups and received subconjunctival injection of 0.5 mL of 0.1% micafungin, 0.2% fluconazole, or physiologic saline once a day for 3 weeks. The eyes were examined slit-lamp biomicroscopically and histopathologically. The clinical course of fungal keratitis was compared among the 3 groups. In another 36 rabbits, a microbiological examination was performed using a quantitative isolate recovery technique, and the numbers of colony-forming units were compared among groups.
The clinical scores were significantly lower in the micafungin group than in the other 2 groups throughout the study period (P < 0.0001 approximately P = 0.0027, Bonferroni multiple comparison). The fluconazole group showed significantly lower clinical scores than the saline group on day 18 (P = 0.0343). At the end of the study period, there were significant differences between the saline and micafungin groups (P < 0.0001), the saline and fluconazole groups (P = 0.0072), and the fluconazole and micafungin groups (P = 0.0013). Histopathologically, similar results were obtained. Moreover, the results of the microbiological examination nearly matched the clinical and histopathologic findings.
Subconjunctival administration of micafungin was effective in the treatment of experimental Candida keratitis. Local application of micafungin to the eye would be a feasible treatment option for clinical fungal keratitis.
与氟康唑相比，评估结膜下注射米卡芬净治疗兔实验性白色念珠菌角膜炎的疗效。
在24只新西兰白兔的1只眼中，将白色念珠菌（5×10酵母细胞）接种于角膜基质。动物被随机分为3组，每天结膜下注射0.5 mL 0.1%米卡芬净、0.2%氟康唑或生理盐水，共3周。通过裂隙灯生物显微镜和组织病理学检查眼睛。比较3组真菌性角膜炎的临床病程。在另外36只兔子中，采用定量分离回收技术进行微生物学检查，并比较各组的菌落形成单位数量。
在整个研究期间，米卡芬净组的临床评分显著低于其他2组（P<0.0001至P = 0.0027，Bonferroni多重比较）。氟康唑组在第18天时的临床评分显著低于生理盐水组（P = 0.0343）。在研究期结束时，生理盐水组与米卡芬净组（P<0.0001）、生理盐水组与氟康唑组（P = 0.0072）以及氟康唑组与米卡芬净组（P = 0.0013）之间存在显著差异。组织病理学检查得到了类似结果。此外，微生物学检查结果与临床和组织病理学发现几乎相符。
结膜下注射米卡芬净对实验性念珠菌角膜炎治疗有效。局部应用米卡芬净治疗临床真菌性角膜炎将是一种可行的治疗选择。
