Posters

Our experience of Pythium keratitis: a clinical diagnostic dilemma, changing trends and challenges in management

Poster Details

First Author: B.Gurnani INDIA

Co Author(s):    J. Christy   S. Narayana   K. Kaur              

Abstract Details

Purpose:

To study demographics, risk factors, clinical challenges , diagnostic dilemmas and treatment outcome in culture proven Pythium keratitis cases

Setting:

Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India

Methods:

Retrospective analysis was performed at our tertiary eye cenrer from Jan 2018 to Nov 2019. Demographics, risk factors, microbiology investigations, clinical course, treatment outcomes, complications and visual outcome were analyzed

Results:

A total of 29 patients with mean age of 38.1 years were included. Visual acuity was 6/9 to PL+. A total of 13 patients were treated with antifungals alone and 18 with 0.2% linezolid and 1% azithromycin.6 patients improved >6/9.19 patients underwent Therapeutic keratoplasty(TPK).14 had graft reinfection,3 developed staphyloma and 4 became phthisical.Of these,12 grafts failed,2 had endophthalmitis. Re‐grafts were performed in 11 eyes, of which 9 failed again. There were no cases of evisceration and globe salvage rate was 75%. 4 patients were lost to follow-up

Conclusions:

Prompt diagnosis,clinical awareness and specific treatment options are needed for managing this devastating entity. Pythium keratitis is more prevalent in younger patients <50 years of age (Majority being students and software engineers). Most common clinical findings are stromal infiltrate with hyphated edges with or without limbal involvement. Around 70 % patients need TPK. Majority had poor response to medical therapy. Globe salvage was around 75%

Financial Disclosure:

None