P Garg1, U Gopinathan, K Choudhary, G N Rao. 1. Sight Savers' Corneal Training Centre, L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India. prashant@lvpeye.stph.net
Abstract
OBJECTIVE: To assess the significance of dematiaceous fungi in the causation of keratomycosis. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Eighty-eight cases of dematiaceous fungal keratitis seen at the L. V. Prasad Eye Institute, Hyderabad, India from January 1991 through December 1996. INTERVENTION: Only culture-proven cases were analyzed. MAIN OUTCOME MEASURES: Predisposing factors, clinical characteristics, microbiology, treatment methods, and outcome. RESULTS: Of 557 cases of fungal keratitis seen during the study period, dematiaceous fungi were the etiologic agents in 88 (15.7%), after Fusarium in 210 (37.6%) and Aspergillus species in 170 cases (30.4%), respectively. Trauma was the most common predisposing factor (47.7%). Fifty-three eyes (61.3%) had the classical clinical picture of yellow-white, dry raised infiltrate with feathery hyphate edges at initial examination. The characteristic macroscopic pigmentation was seen in only 24 eyes (27.27%). Septate branching fungal filaments were identified in 78 smears (88.63%) on light microscopy, of which 5 (5.7%) also showed the presence of bacteria. Curvularia species dominated the spectrum (22.7%). Treatment was started in 48 eyes with topical antifungal agents, whereas 37 received both oral and topical antifungal agents. Outcome data were available for 68 cases. Forty-nine (72%) responded to medical therapy, whereas 13 eyes required therapeutic penetrating keratoplasty and 6 eyes had to be eviscerated. CONCLUSIONS: This is the largest series of keratitis caused by dematiaceous fungi reported to date. It clearly brings out the clinical importance of this group of corneal infections.
OBJECTIVE: To assess the significance of dematiaceous fungi in the causation of keratomycosis. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Eighty-eight cases of dematiaceous fungal keratitis seen at the L. V. Prasad Eye Institute, Hyderabad, India from January 1991 through December 1996. INTERVENTION: Only culture-proven cases were analyzed. MAIN OUTCOME MEASURES: Predisposing factors, clinical characteristics, microbiology, treatment methods, and outcome. RESULTS: Of 557 cases of fungal keratitis seen during the study period, dematiaceous fungi were the etiologic agents in 88 (15.7%), after Fusarium in 210 (37.6%) and Aspergillus species in 170 cases (30.4%), respectively. Trauma was the most common predisposing factor (47.7%). Fifty-three eyes (61.3%) had the classical clinical picture of yellow-white, dry raised infiltrate with feathery hyphate edges at initial examination. The characteristic macroscopic pigmentation was seen in only 24 eyes (27.27%). Septate branching fungal filaments were identified in 78 smears (88.63%) on light microscopy, of which 5 (5.7%) also showed the presence of bacteria. Curvularia species dominated the spectrum (22.7%). Treatment was started in 48 eyes with topical antifungal agents, whereas 37 received both oral and topical antifungal agents. Outcome data were available for 68 cases. Forty-nine (72%) responded to medical therapy, whereas 13 eyes required therapeutic penetrating keratoplasty and 6 eyes had to be eviscerated. CONCLUSIONS: This is the largest series of keratitis caused by dematiaceous fungi reported to date. It clearly brings out the clinical importance of this group of corneal infections.
Authors: A K Leck; P A Thomas; M Hagan; J Kaliamurthy; E Ackuaku; M John; M J Newman; F S Codjoe; J A Opintan; C M Kalavathy; V Essuman; C A N Jesudasan; G J Johnson Journal: Br J Ophthalmol Date: 2002-11 Impact factor: 4.638
Authors: N Venkatesh Prajna; T Krishnan; J Mascarenhas; M Srinivasan; C E Oldenburg; C M Toutain-Kidd; A Sy; S D McLeod; M E Zegans; N R Acharya; T M Lietman; T C Porco Journal: Eye (Lond) Date: 2012-06-29 Impact factor: 3.775
Authors: Rafael A Oechsler; Michael R Feilmeier; Darlene Miller; Wei Shi; Ana Luisa Hofling-Lima; Eduardo C Alfonso Journal: Cornea Date: 2013-05 Impact factor: 2.651