Most Read Articles
Jairia Dela Cruz, 2 days ago
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
11 Sep 2020
Men who use calcium channel blockers (CCBs) are at risk of developing prostate cancer, and the risk increases with the duration of CCB exposure, according to the results of a systematic review and meta-analysis.
06 Sep 2020
Type 2 diabetes mellitus patients taking proton pump inhibitors (PPIs) are at a higher risk of sustaining hip fractures, a recent study has found.
4 days ago
Osteoarthritis (OA) is the most common condition affecting the joints. Dr Lee Eu Jin, an Orthopaedic Surgeon from Liberty Orthopaedic Clinic at Mount Elizabeth Medical Centre, Singapore, shares his insights with Pearl Toh on how to manage OA in the primary care setting.


Adjuvant CXL may worsen vision in patients with moderate fungal keratitis

25 Jan 2020

Treatment with adjuvant corneal cross-linking (CXL) does not seem to produce favourable results in patients with moderate filamentous fungal ulcers and may even lead to reduced visual acuity, a recent study has shown.

Consecutive patients presenting with moderate vision loss from a smear-positive fungal ulcer at Aravind Eye Hospital in Madurai, India, were included in this outcome-masked, two-by-two factorial design, randomized controlled trial.

Study eyes were randomly assigned to one of four treatment combinations using an adaptive randomization protocol. Treatment arms were as follows: topical natamycin 5% alone, topical natamycin 5% plus CXL, topical amphotericin B 0.15% alone, and topical amphotericin 0.15% plus CXL.

Patients who received CXL, irrespective of medication (topical natamycin or amphotericin), showed 1.32-fold higher odds of 24-hour culture positivity, albeit statistically nonsignificant (95 percent confidence interval [CI], 0.57–3.06; p=0.51). There was also no difference found in 24-hour culture positivity between patients on amphotericin and those on natamycin when evaluating as a group regardless of whether they received CXL or not (coefficient, 1.10, 95 percent CI, 0.47–2.54; p=0.84).

Among patients receiving CXL regardless of medication, the best spectacle-corrected visual acuity (BSCVA) was approximately 0.22 logMAR (2.2 Snellen lines) worse on average at 3 weeks and 0.32 logMAR (3.2 Snellen lines) worse at 3 months after controlling for baseline visual acuity (95 percent CI, 0.03–0.54; p=0.02).

When comparing CXL with no CXL or the two topical medications, no difference was observed in infiltrate or scar size, percentage of epithelialized or adverse events.

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Most Read Articles
Jairia Dela Cruz, 2 days ago
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
11 Sep 2020
Men who use calcium channel blockers (CCBs) are at risk of developing prostate cancer, and the risk increases with the duration of CCB exposure, according to the results of a systematic review and meta-analysis.
06 Sep 2020
Type 2 diabetes mellitus patients taking proton pump inhibitors (PPIs) are at a higher risk of sustaining hip fractures, a recent study has found.
4 days ago
Osteoarthritis (OA) is the most common condition affecting the joints. Dr Lee Eu Jin, an Orthopaedic Surgeon from Liberty Orthopaedic Clinic at Mount Elizabeth Medical Centre, Singapore, shares his insights with Pearl Toh on how to manage OA in the primary care setting.