Impact of corticosteroids in fungal keratitis

Session Details

Session Title: Cornea: Medical

Session Date/Time: Tuesday 10/10/2017 | 08:00-10:30

Paper Time: 08:36

Venue: Room 3.6

First Author: : K.Belkhadir MOROCCO

Co Author(s): :    Z. Bettich   I. Sabrane   M. El Ikhloufi   A. Amazouzi   R. Daoudi   O. Cherkaoui     

Abstract Details

Purpose:

Fungal keratitis are serious infections of the cornea, most often occurring in a fragile context. Corticosteroid therapy is contraindicated when a mycotic origin of the abscess is suspected. In our context, patients have easy access to corticosteroids and use them as auto-medication. The aim of our work was to analyze the specific complications of corticosteroids in case of fungal keratitis.

Setting:

Ophtalmology A Unit at the Ibn Sina university Hospital in Rabat, Morocco.

Methods:

This is a retrospective study carried out in the Ophtalmology A Unit at the Ibn Sina university Hospital in Rabat, Morocco. All patients admitted for fungal keratitis management were included between October 2014 and October 2016.

Results:

We collected 27 cases of fungal keratitis. Twelve patients used corticosteroid eye drops before hospitalization. These patients had larger abscesses with a mean major axis of 6 mm vs. 4 mm (p = 0.004). These abscesses were complicated with decemetocoelia in 8 cases vs. 3 cases (p = 0.022). During treatment, patients who received corticosteroids had more corneal perforations occurring in 9 cases vs 4 cases (p = 0.013) and posterior synechiae in 10 cases (37%) vs 5 cases (18.5%) (p = 0.009). This resulted in an increased length of hospital stay (22.7 days vs. 17.9 days. p = 0.046)

Conclusions:

The use of corticosteroids in mycotic keratitis leads to more serious and wider lesions, providing more complications, in particular of corneal perforations and posterior synechiae.

Financial Disclosure:

NONE