Loh Allison R, Hong Kevin, Lee Salena, Mannis Mark, Acharya Nisha R
University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Cornea. 2009 Sep;28(8):856-9. doi: 10.1097/ICO.0b013e318199fa77.
The purpose of this study was to determine the practice patterns of ophthalmologists in the management of fungal corneal ulcers.
In December 2007, a survey of 13 questions addressing the actual and preferred treatment of fungal ulcers was sent to the kera-net e-mail listserv facilitated by the Cornea Society.
Ninety-two respondents from North America, South America, Asia, Europe, and Australia participated by completing the electronic questionnaire. Natamycin was the most commonly used topical treatment for ulcers caused by filamentous fungi (96%) followed by amphotericin (75%) and voriconazole (63%). However, voriconazole was most often listed as the preferred topical treatment in an ideal world (79%) compared with 55% for natamycin. Approximately half of the respondents use combination topical therapy (56%) and the remainder monotherapy. The majority of respondents rescrape the epithelium at some time during the course of treatment, but the frequency of rescraping varied among the different topical treatments. The most common reasons cited for not using their preferred treatment were cost and a desire for further evidence to support preferred treatment.
There appears to be significant variation in the management of fungal corneal ulcers. Although natamycin was the most commonly used treatment for ulcers caused by filamentous fungi, voriconazole was the most preferred as the ideal treatment. These results highlight the need for more evidence regarding the efficacy of the newer topical antifungals.
本研究的目的是确定眼科医生在真菌性角膜溃疡治疗中的实践模式。
2007年12月，向由角膜学会推动的kera-net电子邮件列表发送了一份包含13个问题的调查问卷，涉及真菌性溃疡的实际治疗和首选治疗。
来自北美、南美、亚洲、欧洲和澳大利亚的92名受访者通过填写电子问卷参与了调查。那他霉素是丝状真菌引起的溃疡最常用的局部治疗药物（96%），其次是两性霉素（75%）和伏立康唑（63%）。然而，在理想情况下，伏立康唑最常被列为首选局部治疗药物（79%），而那他霉素为55%。大约一半的受访者使用联合局部治疗（56%），其余使用单一疗法。大多数受访者在治疗过程中的某个时间会再次刮除上皮，但不同局部治疗的再次刮除频率有所不同。未使用首选治疗方法的最常见原因是成本以及希望获得更多证据支持首选治疗。
真菌性角膜溃疡的治疗似乎存在显著差异。虽然那他霉素是丝状真菌引起的溃疡最常用的治疗药物，但伏立康唑是理想治疗的首选。这些结果凸显了需要更多关于新型局部抗真菌药物疗效的证据。
