PURPOSE: To review cases of culture-positive fungal keratitis seen at Moorfields Eye Hospital over a 13-year period to January 2007. METHODS: Isolates were identified retrospectively from laboratory reports. The clinical records were reviewed. The fungal type, risk factors for infection, in vitro sensitivity, and clinical outcome were recorded. RESULTS: There were 66 isolates from 65 patients (men, 53.8%). Forty (60.6%) of the isolates were subspecies of Candida. The average interval from the onset of keratitis to confirmation of fungal infection was 3.4 weeks (median, 1.0 week; range, 0-16 weeks). Prior ocular surface disease (OSD) or a penetrating keratoplasty (PK) was present in 38 (97.4%) patients with Candida infection, and 29 (74.4%) patients with Candida infection were using topical steroid at the time of diagnosis. The principal risk factors for filamentary fungal infection were trauma (8 cases, 30.8%) or cosmetic contact lens wear (8 cases, 30.8%), with OSD or a prior PK each present in 5 (19.2%) cases. The difference in the proportions of risk factors between the 2 fungal groups was statistically significant (P < 0.000). The visual outcome was similar between groups, and at final review, 27 (41.5%) eyes had a visual acuity of < or = 1/60 and 3 (4.6%) eyes were eviscerated. In vitro sensitivity testing showed full or part sensitivity in 100% of 55 isolates tested against econazole, 87.9% of 58 isolates tested against amphotericin, 75% of 40 isolates tested against itraconazole, and 100% of 20 isolates tested against voriconazole. CONCLUSIONS: Candida was the principal isolate, usually from eyes with OSD or a prior PK treated with topical steroids.
PURPOSE: To review cases of culture-positive fungal keratitis seen at Moorfields Eye Hospital over a 13-year period to January 2007. METHODS: Isolates were identified retrospectively from laboratory reports. The clinical records were reviewed. The fungal type, risk factors for infection, in vitro sensitivity, and clinical outcome were recorded. RESULTS: There were 66 isolates from 65 patients (men, 53.8%). Forty (60.6%) of the isolates were subspecies of Candida. The average interval from the onset of keratitis to confirmation of fungal infection was 3.4 weeks (median, 1.0 week; range, 0-16 weeks). Prior ocular surface disease (OSD) or a penetrating keratoplasty (PK) was present in 38 (97.4%) patients with Candida infection, and 29 (74.4%) patients with Candida infection were using topical steroid at the time of diagnosis. The principal risk factors for filamentary fungal infection were trauma (8 cases, 30.8%) or cosmetic contact lens wear (8 cases, 30.8%), with OSD or a prior PK each present in 5 (19.2%) cases. The difference in the proportions of risk factors between the 2 fungal groups was statistically significant (P < 0.000). The visual outcome was similar between groups, and at final review, 27 (41.5%) eyes had a visual acuity of < or = 1/60 and 3 (4.6%) eyes were eviscerated. In vitro sensitivity testing showed full or part sensitivity in 100% of 55 isolates tested against econazole, 87.9% of 58 isolates tested against amphotericin, 75% of 40 isolates tested against itraconazole, and 100% of 20 isolates tested against voriconazole. CONCLUSIONS: Candida was the principal isolate, usually from eyes with OSD or a prior PK treated with topical steroids.
Authors: Lawson Ung; Paulo J M Bispo; Swapna S Shanbhag; Michael S Gilmore; James Chodosh Journal: Surv Ophthalmol Date: 2018-12-24 Impact factor: 6.048
Authors: M Roth; L Daas; A Renner-Wilde; N Cvetkova-Fischer; M Saeger; M Herwig-Carl; M Matthaei; A Fekete; V Kakkassery; G Walther; M von Lilienfeld-Toal; C Mertens; J Lenk; J Mehlan; C Fischer; M Fuest; S Kroll; W Bayoudh; A Viestenz; A Frings; C R MacKenzie; E M Messmer; B Seitz; O Kurzai; G Geerling Journal: Ophthalmologe Date: 2019-10 Impact factor: 1.059
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