Clinical outcomes in fungal corneal ulcers treated with topical voriconazole

Session Details

Session Title: Cornea - Medical

Session Date/Time: Monday 07/09/2015 | 08:00-10:30

Paper Time: 09:33

Venue: Room 17

First Author: : B.Juarez Dominguez MEXICO

Co Author(s): :    A. Perez-Balbuena   N. Ramos-Betancourt   J. Martinez              

Abstract Details

Purpose:

To report our experience in the use of topical voriconazole as primary treatment in keratomycosis cases, describing risk factors, clinical evolution and outcomes.

Setting:

Asociacion para Evitar la Ceguera (APEC) in Mexico City.

Methods:

Eyes with history of keratomycosis and primary treated with topical voriconazole were reviewed from 2012 to 2014. The information analyzed included the clinical presentation, evolution and mean corrected distance visual acuity (CDVA).

Results:

Fifty three eyes were evaluated. Mean patient age was 46.25 (±16.39) years (range, 7-83). Patients symptomatically prior to presentation for 29.25 days mean (range, 1-180), 90.6% of patients had prior treatment, fluoroquinolones (71.7%), and aminoglycosides (42.3%). Major risk factors were, trauma with vegetables (20.8%), and diabetes mellitus (17%). Fusarium solani was the primary isolated fungus (20.9%) followed by Aspergillus flavus (14%) . The initial CDVA was 20/2000 (logMAR, 2.5). The infection was solved in 77.3%. Complications: leucoma 27 (50.9%), and corneal perforation in 12 (22.6%) eyes. Four eyes were eviscerated.

Conclusions:

This is the first study to report the use of topical voriconazole as a primary treatment in keratomycosis in a tertiary care ophthalmology center in Mexico. Our success rate was of 77.3%, higher than other publications. Current evidence support the use of voriconazole as a primary treatment for selective cases.

Financial Interest:

NONE