TNOA Journal of Ophthalmic Science and Research

OPHTHALMIC IMAGES
Year
: 2020  |  Volume : 58  |  Issue : 3  |  Page : 218--219

Dragon plaque – natamycin drug deposit masquerading as fungal infiltrate


Bharat Gurnani, Kirandeep Kaur, Josephine Christy, Shivananda Narayana 
 Cataract, Cornea and Refractive Services, Aravind Eye Hospital, Puducherry, India

Correspondence Address:
Dr. Kirandeep Kaur
Fellow Pediatric and Squint Services, Aravind Eye Hospital, Puducherry
India




How to cite this article:
Gurnani B, Kaur K, Christy J, Narayana S. Dragon plaque – natamycin drug deposit masquerading as fungal infiltrate.TNOA J Ophthalmic Sci Res 2020;58:218-219


How to cite this URL:
Gurnani B, Kaur K, Christy J, Narayana S. Dragon plaque – natamycin drug deposit masquerading as fungal infiltrate. TNOA J Ophthalmic Sci Res [serial online] 2020 [cited 2020 Oct 30 ];58:218-219
Available from: https://www.tnoajosr.com/text.asp?2020/58/3/218/294989


Full Text



A 50-year-old male presented with sugarcane leaf injury in the right eye (OD) 2 months back. Best-corrected visual acuity in OD was hand moments, and the left eye (OS) was 20/20. Ocular examination in OD revealed circumcorneal congestion, central anterior feathery stromal infiltrate, stromal edema, Descemet membrane folds, satellite lesions, trace hypopyon with clear lens [Figure 1]. Corneal scraping revealed fungal filaments on Gram and KOH stain. Patients were treated with antifungals for 2 months. The corneal infiltrate showed excellent resolution. On the last review, ocular examination revealed natamycin plaque [Figure 2] over the cornea masquerading as residual fungal infiltrate. Natamycin is a tetraene polyene which has been regarded as the most important agent in the management of fungal keratitis.[1] Chronic long-term administration of natamycin can lead to the formation of plaque over the corneal surface, which can masquerade as infiltrate.[2],[3]{Figure 1}{Figure 2}

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Arora R, Gupta D, Goyal J, Kaur R. Voriconazole versus natamycin as primary treatment in fungal corneal ulcers. Clin Exp Ophthalmol 2011;39:434-40.
2Prajna NV, Krishnan T, Mascarenhas J, Rajaraman R, Prajna L, Srinivasan M, et al. The mycotic ulcer treatment trial: A randomized trial comparing natamycin vs voriconazole. JAMA Ophthalmol 2013;131:422-9.
3Wang DM, Chen GS, Huang MH. Observation of therapeutical effect of natamycin in fungal corneal ulcer. Guoji Yanke Zazhi (Int Eye Sci) 2010;10:744-5.