Posters

Fungal keratitis: a 5-year study

Poster Details

First Author: K.Belkhadir MOROCCO

Co Author(s): M. Boutkhil   M. El Ikhloufi   Y. Boubnan   L. El Kaissoumi   A. Amazouzi   O. Cherkaoui     

Abstract Details

Purpose:

Fungal keratitis are serious corneal infections, which most commonly occur on fragile corneas or on an immunosuppressed patient. Their diagnosis is based on a cluster of anamnestic, clinical, and microbiological arguments. The initial clinical aspect, as well as the evolution during the treatment, constitute key elements in our context, to evoke the diagnosis of fungal keratitis. The aim of our study was therefore to study the characteristics of the epidemiological, diagnostic, therapeutic and prognostic aspects of fungal keratitis in our Moroccan context.

Setting:

Ophthalmology Unit A, Hopital des Specialites, Mohammed V University in Rabat, Morocco

Methods:

We retrospectively collected the records of all the consecutive patients hospitalized between October 2014 and July 2019, for fungal keratitis. The inclusion criteria were as follows: patients with mycological evidence, and / or patients with at least three of the clinical signs strongly suggestive of fungal keratitis: Context of trauma by plant agent; An immunosuppression; An abscess with blurred, fluffy edges on a greyish, rough cornea; Micro satellite abscesses; Presence of flakes in the anterior chamber. The non-improvement under antibiotic eye drops, then the improvement under antimycotic treatment was also retained as inclusion criterion.

Results:

We collected 58 patients. Ocular trauma and local corticosteroid therapy were found in 53,4% and 39.7% of patients respectively. The mean time between the first clinical signs and the consultation was 18 days. The initial visual acuity ranged from 2/10 to no luminous perception. All patients received corneal scratching at their admission. It confirmed the clinical suspicion of fungal keratitis in 51.7% of the cases.The evolution was marked by the occurrence of corneal perforation in 24,1% of patients, a corneal opacity in 94.8% of the cases. An improvement in visual acuity was observed in 36 of our patients.

Conclusions:

Fungal keratitis represent severe infections. In Morocco, like in many others countries, we have to adapt our diagnosis and therapeutic protocols according too our conditions. The particular clinical features of mycotic disease are of great help in diagnostic. The mycological data are still insufficient, and most often confirm a strong clinical presumption. The prognosis is conditioned by an early diagnosis and the rapid initiation of an effective treatment, in order to avoid the frequent, sometimes even blinding complications of these infections

Financial Disclosure:

None