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CASE REPORT
Year : 2017  |  Volume : 7  |  Issue : 4  |  Page : 224-226

Rapid resolution of stromal keratitis with the assistance of oral voriconazole in resistant acanthamoeba keratitis


1 Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
2 Department of Ophthalmology, Cheng Hsin General Hospital, Taipei, Taiwan
3 Department of Ophthalmology, Taipei Veterans General Hospital; Institute of Clinical Medicine, National Yang-Ming University, Taiwan

Correspondence Address:
Chih-Chien Hsu
Department of Ophthalmology, Taipei Veterans General Hospital, Institute of Clinical Medicine, National Yang-Ming University, Taipei
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjo.tjo_73_17

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Acanthamoeba keratitis (AK) is an unusual infectious disease of the cornea which sometimes leads to blindness. We report the experience of adding oral voriconazole in conjunction with topical antiacanthamoebic drops to treat refractory AK. A 20-year-old girl experienced a deep stromal keratitis with large epithelial defect in the left eye, suspected as AK. The initial best-corrected visual acuity (BCVA) of the eye was counting finger. She received topical chlorhexidine 0.02% and voriconazole 1% during the first 14 days but in vain. Oral voriconazole was administered and resulted in a rapid regression of the lesion. A total resolution was achieved after 2 weeks of triple combination therapy. The BCVA of the left eye finally achieved 20/20 at 6-month follow-up. Although oral voriconazole was seldom used in treating acute AK, the additional use of oral voriconazole combined with topical antiacanthamoebic drugs may help to achieve a successful treatment effect in refractory stromal AK.


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