Fungal keratitis at a tertiary eye care in Northern Thailand: Etiology and prognostic factors for treatment outcomes - 19/06/21
, Phit Upaphong a, Chulaluck Tangmonkongvoragul a, Muanploy Niparugs a, Winai Chaidaroon a, Monsicha Pongpom bHighlights |
• | Ocular trauma with vegetative matter is a major risk factor of fungal keratitis. |
• | Dematiaceous fungi are emerging organisms causing fungal keratitis. |
• | Many cases of fungal keratitis require surgical intervention. |
• | Aging, delayed antifungal drugs and a large lesion are predictors of poor outcomes. |
Abstract |
Purpose |
To evaluate etiology and prognostic factors for treatment outcomes of fungal keratitis (FK).
Methods |
Culture-positive FK patients between 2012 and 2017 were reviewed. Treatment outcomes were categorized into success (resolved within two weeks), slow response and medication failure (no improvement or required surgery). Etiology and risk factors for poor treatment outcomes were analyzed.
Results |
A total of 113 eyes of 113 patients (77% males) were recruited. Ocular trauma (69.0%) was the most common predisposing factor. Of this, 80% were exposed to organic foreign bodies. The most common pathogen was Fusarium spp. (45.2%), while dematiaceous fungi were discovered in 29.6%. Medical treatment was successful in 24.8% of eyes, while 29.2% had a slow response and 42.5% failed medication. Therapeutic keratoplasty was performed in 22.1% of eyes and 11.5% eventually required eye removal. Significant risk factors for medication failure were advanced age (P = 0.005), delayed antifungal treatment (P = 0.038) and large-size lesion (P = 0.003).
Conclusions |
Ocular trauma was the major predisposing factor of FK in the Northern Thailand. Fusarium was the most common identified pathogen. Many cases were refractory to medications and required surgical intervention. Aging, delayed treatment and a large lesion were predictors for poor outcomes.
Le texte complet de cet article est disponible en PDF.Keywords : Corneal infection, corneal ulcer, fungal keratitis, treatment outcome, dematiaceous fungi
Plan
Vol 83 - N° 1
P. 112-118 - juillet 2021 Retour au numéro
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