Journal of Clinical and Experimental Ophthalmology
Open Access
ISSN: 2155-9570
+44 1223 790975
ISSN: 2155-9570
+44 1223 790975
Nazire Demirci, Ozlem Tok, Emel Sesli Cetin, Kemal Kursat Bozkurt, Sirin Baspinar, Levent Tok and Esra Ciftci
Purpose: The aim of this study was to compare the clinical, microbiological, and histopathological effects of topical caspofungin, anidulafungin, and voriconazole in the treatment of Candida albicans keratitis.
Methods: Candida albicans (ATCC 10231) was inoculated on the mechanically de-epithelialized corneas of 28 male New Zealand White rabbits. Topical treatment was initiated after 72 h of inoculation. The rabbits were randomly assigned to treatment with 0.9% NaCl (control group), 0.5% caspofungin, 0.5% anidulafungin, or 1% voriconazole (n=6 rabbits per group). Eye drops were instilled every 30 minutes for the first 12 h, then hourly for 3 days. Clinical evaluations were done after 36 and 72 h of treatment. Clinical evaluation scores were calculated. Twelve hours after the final topical application, corneal tissue was removed under general anesthesia. In sterile conditions, the excised corneas were divided into two pieces for histopathological and microbiological examination. The efficacies of the treatments were measured by clinical assessment, fungal culture, and histopathology.
Results: After 72 h of treatment, mean clinical assessment scores of the control, caspofungin, anidulafungin, and voriconazole groups were 9.60 ± 0.54 (9-10), 4.66 ± 1.63 (3-7), 2.50 ± 0.83 (1-3), and 6.50 ± 1.64 (4-8), respectively. Viable cell counts of the groups were 5549.20 ± 5113.54 (857.14-13333.33), 809.52 ± 1120.00 (0-2857.14), 0, and 8678.57 ± 10078.62 (0-25000) CFU/g, respectively. Histopathological analysis yielded mean hyphal densities of 50 μm, 20 μm, 0 μm, and 85 μm, respectively.
Conclusions: According to clinical, microbiological, and pathological data, the most effective agent against Candida albicans keratitis was anidulafungin, followed by caspofungin.