PURPOSE: To report the spectrum of fungal keratitis at the Centre Hospitalier National d'Ophtalmologie XV-XX, Paris. METHODS: We reviewed 19 cases of fungal keratitis from January 1993 to January 2001. We evaluated the different risk factors, fungal identification, topical and systemic antifungal therapy, surgical treatment and outcome. RESULTS: Nineteen patients were included, 7 women and 12 men, with visual acuity ranging from 9/10 to no perception of light. The mean age was 56.2 years. Patients were hospitalized for an average stay of 16.3 days and all received a diagnostic and therapeutic scraping and 16 received a local antifungal treatment. The most common risk factors were topical steroid treatment (42.1%), corneal graft (31.6%), trauma or foreign body (31.6%). The mean delay between the first signs and fungal keratitis diagnosis was 14 days. Yeast as Candida parapsilosis and albicans were the most frequently isolated fungi (58%), followed by Aspergillus sp. (21%) and Fusarium sp. (21%). The most commonly used topical treatment was amphotericin B, and itraconazole was used as systemic treatment. Five patients had evisceration, 6 had penetrating keratoplasty and 5 retained leukoma. CONCLUSION: Candida was the most frequently isolated fungi and topical steroid treatment the main risk factor. The prognosis is relatively poor (26% of lost vision) because of a delay in diagnosis and other previous ocular pathology or surgery.
PURPOSE: To report the spectrum of fungal keratitis at the Centre Hospitalier National d'Ophtalmologie XV-XX, Paris. METHODS: We reviewed 19 cases of fungal keratitis from January 1993 to January 2001. We evaluated the different risk factors, fungal identification, topical and systemic antifungal therapy, surgical treatment and outcome. RESULTS: Nineteen patients were included, 7 women and 12 men, with visual acuity ranging from 9/10 to no perception of light. The mean age was 56.2 years. Patients were hospitalized for an average stay of 16.3 days and all received a diagnostic and therapeutic scraping and 16 received a local antifungal treatment. The most common risk factors were topical steroid treatment (42.1%), corneal graft (31.6%), trauma or foreign body (31.6%). The mean delay between the first signs and fungal keratitis diagnosis was 14 days. Yeast as Candida parapsilosis and albicans were the most frequently isolated fungi (58%), followed by Aspergillus sp. (21%) and Fusarium sp. (21%). The most commonly used topical treatment was amphotericin B, and itraconazole was used as systemic treatment. Five patients had evisceration, 6 had penetrating keratoplasty and 5 retained leukoma. CONCLUSION:Candida was the most frequently isolated fungi and topical steroid treatment the main risk factor. The prognosis is relatively poor (26% of lost vision) because of a delay in diagnosis and other previous ocular pathology or surgery.
Authors: P Troke; G Obenga; T Gaujoux; P Goldschmidt; A-L Bienvenu; M Cornet; F Grenouillet; D Pons; S Ranque; K Sitbon; C Chaumeil; V Borderie; O Lortholary Journal: Infection Date: 2012-06-21 Impact factor: 3.553
Authors: Ana Maria Cunha; João Tiago Loja; Luís Torrão; Raúl Moreira; Dolores Pinheiro; Fernando Falcão-Reis; João Pinheiro-Costa Journal: Clin Ophthalmol Date: 2020-11-12
Authors: Hon Shing Ong; Simon S M Fung; David Macleod; John K G Dart; Stephen J Tuft; Matthew J Burton Journal: Am J Ophthalmol Date: 2016-06-07 Impact factor: 5.258