Garg Prashant, Roy Aravind, Roy Sanhita
aTej Kohli Cornea Institute, KAR campus, L. V. Prasad Eye Institute, Hyderabad bTej Kohli Cornea Institute, KVC campus, L. V. Prasad Eye Institute, Vijayawada cBrien Holden Eye Research Centre, L. V. Prasad Eye Institute, Hyderabad, Andhra Pradesh, India.
Curr Opin Ophthalmol. 2016 Jul;27(4):333-9. doi: 10.1097/ICU.0000000000000272.
The aim of this review article is to present an overview of some of the seminal work published in the last 18 months (July 2014 to December 2015).
The published literature highlights the need for the identification of fungal isolates to species and subspecies level using molecular methods. Molecular methods helped us identify some of the unknown fungi such as Pythium - fungi that causes keratitis unresponsive to conventional antifungal therapy. Although not popular fungal in-vitro susceptibility tests are showing better correlation between resistance and clinical outcomes. Several groups are trying to understand host responses controlling disease production as well as inflammation. On therapy front researchers are working to develop drug formulations and delivery systems that will provide superior pharmacokinetics and bioavailability. Collagen cross-linking and injections of antifungal agents into the corneal stroma and anterior chamber continue to be attractive to clinicians and more and more researchers are publishing their experiences.
It is an interesting time in the history of mycotic keratitis with a lot of positive developments. Molecular methods will help improved diagnosis and clinico-therapeutic correlation. Drug delivery devices with superior pharmacokinetics are on horizon.
本文综述的目的是概述过去18个月（2014年7月至2015年12月）发表的一些开创性研究。
已发表的文献强调了使用分子方法将真菌分离株鉴定到种和亚种水平的必要性。分子方法帮助我们鉴定了一些未知真菌，如腐霉菌——一种可导致对传统抗真菌治疗无反应的角膜炎的真菌。尽管真菌体外药敏试验并不常用，但它在耐药性与临床结果之间显示出更好的相关性。多个研究团队正在努力了解控制疾病发生以及炎症的宿主反应。在治疗方面，研究人员正在致力于开发能提供更优药代动力学和生物利用度的药物制剂和给药系统。胶原交联以及向角膜基质和前房注射抗真菌药物仍然吸引着临床医生，并且越来越多的研究人员发表了他们的经验。
在真菌性角膜炎的历史上，这是一个有着诸多积极进展的有趣时期。分子方法将有助于改善诊断以及临床治疗相关性。具有更优药代动力学的给药装置即将出现。
