New to MyHealth?
Manage Your Care From Anywhere.
Access your health information from any device with MyHealth. You can message your clinic, view lab results, schedule an appointment, and pay your bill.
ALREADY HAVE AN ACCESS CODE?
DON'T HAVE AN ACCESS CODE?
NEED MORE DETAILS?
MyHealth for Mobile
Adjunctive Oral Voriconazole Treatment of Fusarium Keratitis A Secondary Analysis From the Mycotic Ulcer Treatment Trial II
Adjunctive Oral Voriconazole Treatment of <i>Fusarium</i> Keratitis A Secondary Analysis From the Mycotic Ulcer Treatment Trial II JAMA OPHTHALMOLOGY Prajna, N., Krishnan, T., Rajaraman, R., Patel, S., Shah, R., Srinivasan, M., Devi, L., Das, M., Ray, K. J., O'Brien, K. S., Oldenburg, C. E., McLeod, S. D., Zegans, M. E., Acharya, N. R., Lietman, T. M., Rose-Nussbaumer, J., Mycotic Ulcer Treatment Trial Grp 2017; 135 (6): 520-525Abstract
Fusarium keratitis is common and often results in poor outcomes. No new treatments since natamycin have become available.To explore the role of adjuvant oral voriconazole on clinical outcomes in Fusarium keratitis.In this prespecified subgroup analysis of a multicenter, double-masked, placebo-controlled randomized clinical trial, 240 patients from the Aravind Eye Care System in India, the Lumbini Eye Hospital and Bharatpur Eye Hospital in Nepal, and the University of California, San Francisco, who had culture-positive fungal ulcer and baseline visual acuity of 20/400 or worse were randomized to receive oral voriconazole vs placebo. Enrollment started May 24, 2010, and the last patient study visit was November 23, 2015. All patients received topical voriconazole, 1%, and after the results of the Mycotic Ulcer Treatment Trial (MUTT) II became available, topical natamycin, 5%, was added for all patients. Data analysis was performed from September 2 to October 28, 2016.The primary outcome of the trial was the rate of corneal perforation or the need for therapeutic penetrating keratoplasty. Secondary outcomes included rate of reepithelialization, best spectacle-corrected visual acuity, and infiltrate or scar size at 3 months.Of the 240 study participants, 72 (30.4%) were culture positive for Fusarium species (41 [56.9%] male and 31 [43.1%] female; median [interquartile range] age, 50 [45-57] years). Of these, 33 (45.8%) were randomized to oral voriconazole and 39 (54.2%) to placebo. Fusarium ulcers randomized to oral voriconazole had a 0.43-fold decreased hazard of perforation or therapeutic penetrating keratoplasty compared with placebo after controlling for baseline infiltrate depth (95% CI, 0.22-fold to 0.84-fold; P?=?.01). Multiple linear regression revealed a 1.89-mm decreased infiltrate and/or scar size at 3 weeks (95% CI, -2.69 to -1.09 mm; P?
View details for DOI 10.1001/jamaophthalmol.2017.0616
View details for Web of Science ID 000403471700007
View details for PubMedID 28426856
View details for PubMedCentralID PMC5847083