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Ocular toxicity of topical antifungal agents
Abstract:
We studied, in a rabbit, the ocular toxicity of topical 1% solutions or suspensions of amphotericin B, flucytosine, miconazole nitrate, and ketoconazole. Flucytosine, miconazole, and ketoconazole did not retard the closure of 8.5-mm corneal epithelial defects; amphotericin B greatly retarded the closure of such defects. Amphotericin B produced dramatic pathologic changes in this model; these changes worsened with each day of therapy. Ketoconazole produced modest biomicroscopically and histologically detectable pathologic changes in the regenerating corneal epithelium; flucytosine and miconazole did not produce such changes.
Insights
Topical antifungals were tested for eye toxicity in rabbits. Amphotericin B significantly delayed corneal healing and caused severe damage, unlike other tested antifungals.
Area of Science:
- Ophthalmology
- Pharmacology
- Toxicology
Background:
- Topical antifungal agents are used to treat ocular infections.
- Understanding the ocular toxicity of these agents is crucial for patient safety.
Purpose of the Study:
- To evaluate the ocular toxicity of topical 1% solutions or suspensions of amphotericin B, flucytosine, miconazole nitrate, and ketoconazole in a rabbit model.
Main Methods:
- Corneal epithelial defects (8.5-mm) were created in rabbits.
- The closure rate of these defects was monitored after topical application of the antifungal agents.
- Ocular tissues were examined for pathological changes.
Main Results:
- Amphotericin B significantly retarded the closure of corneal epithelial defects.
- Amphotericin B caused severe, progressive ocular pathological changes.
- Ketoconazole induced modest pathological changes, while flucytosine and miconazole did not significantly affect healing or cause notable toxicity.
Conclusions:
- Amphotericin B exhibits significant ocular toxicity and impairs corneal healing.
- Flucytosine, miconazole, and ketoconazole appear to be safer alternatives regarding ocular surface toxicity in this model.