Yoshitsugu Inoue1, Yuichi Ohashi2, Yoshikazu Shimomura3, Chie Sotozono4, Hiroshi Hatano5, Masahiko Fukuda6, Hiroshi Eguchi7, Kaoru Araki-Sasaki8, Takashi Suzuki9, Saichi Hoshi10, Seishi Asari11, Atsuko Sunada11, Keigo Kimura11, Takashi Yaguchi12, Koichi Makimura13. 1. Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan. yoinoue@grape.med.tottori-u.ac.jp. 2. Department of Ophthalmology, Minami-Matsuyama Hospital, Matsuyama, Ehime, Japan. 3. Department of Ophthalmology, Fuchu Eye Center, Izumi, Osaka, Japan. 4. Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan. 5. Hatano Eye Clinic, Fujisawa, Kanagawa, Japan. 6. Department of Ophthalmology, Kindai University Nara Hospital, Ikoma, Nara, Japan. 7. Department of Ophthalmology, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan. 8. Department of Ophthalmology, Kansai Medical University, Hirakata, Osaka, Japan. 9. Department of Ophthalmology, Faculty of Medicine, Toho University, Tokyo, Japan. 10. Horikiri Eye Clinic, Tokyo, Japan. 11. Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan. 12. Medical Mycology Research Center, Chiba University, Chiba, Japan. 13. Institute of Medical Mycology, Teikyo University, Tokyo, Japan.
Abstract
PURPOSE: To investigate the clinical characteristics and causative fungi in patients with fungal keratitis in Japan, and to determine factors related to the prognosis. STUDY DESIGN: Multicenter prospective observational study. METHODS: Eligible patients were enrolled from November 2011 to October 2013 at the 1st stage and from April 2015 to March 2016 at the 2nd stage. The corneal foci were scraped, and the scrapings were cultured in potato dextrose agar. The isolated fungi were identified by gene analyses. Data were collected from the clinical records and statistically analyzed by Cox and logistic regression analyses. RESULTS: Ninety-four fungal strains were isolated from 93 cases, including 42 yeast-like fungi and 52 filamentous fungi. The fungi affected the deep layers of the cornea in 23 cases (24.7%) and the peripheral cornea in 29 cases (31.2%). The incidences of lid swelling/redness, ciliary injection, anterior chamber cells/flare, anterior chamber fibrin, and hyphate ulcer in cases of filamentous fungi were significantly higher than in yeast-like fungi. No history of topical steroids, absence of a main lesion in the peripheral cornea, and best-corrected visual acuity (BCVA) of more than 0.04 at the first visit were related to a shorter healing time. No history of ocular surgery, absence of lesion at one-third deep stromal layer and BCVA of more than 0.04 at the first visit were correlated with BCVA at 3 months after the initial examination. CONCLUSION: Fungal keratitis is caused by various species of fungi and can become refractory due to poor prognosis factors.
PURPOSE: To investigate the clinical characteristics and causative fungi in patients with fungal keratitis in Japan, and to determine factors related to the prognosis. STUDY DESIGN: Multicenter prospective observational study. METHODS: Eligible patients were enrolled from November 2011 to October 2013 at the 1st stage and from April 2015 to March 2016 at the 2nd stage. The corneal foci were scraped, and the scrapings were cultured in potato dextrose agar. The isolated fungi were identified by gene analyses. Data were collected from the clinical records and statistically analyzed by Cox and logistic regression analyses. RESULTS: Ninety-four fungal strains were isolated from 93 cases, including 42 yeast-like fungi and 52 filamentous fungi. The fungi affected the deep layers of the cornea in 23 cases (24.7%) and the peripheral cornea in 29 cases (31.2%). The incidences of lid swelling/redness, ciliary injection, anterior chamber cells/flare, anterior chamber fibrin, and hyphate ulcer in cases of filamentous fungi were significantly higher than in yeast-like fungi. No history of topical steroids, absence of a main lesion in the peripheral cornea, and best-corrected visual acuity (BCVA) of more than 0.04 at the first visit were related to a shorter healing time. No history of ocular surgery, absence of lesion at one-third deep stromal layer and BCVA of more than 0.04 at the first visit were correlated with BCVA at 3 months after the initial examination. CONCLUSION: Fungal keratitis is caused by various species of fungi and can become refractory due to poor prognosis factors.
Authors: Y Mitsui; S Kitano; Y Uchida; N Tanaka; S Kobayashi; H Tokuda; M Ooishi; K Shimada; J Hara; H Shiota Journal: Nippon Ganka Gakkai Zasshi Date: 1982-12-10