Posters

Fungal keratitis: diagnosis and treatment outcomes

Poster Details

First Author: A.Rodriguez SPAIN

Co Author(s):    J. Alio del Barrio   A. Vega   J. Alio              

Abstract Details

Purpose:

The fungal keratitis (keratomycosis) represents for the ophthalmologist one of the most difficult forms of infectious keratitis in terms of an adequate diagnosis and treatment. The objective of this work is to present the microbiological results obtained and the treatments used to combat this type of infections.

Setting:

This is a retrospective review of the records of consecutive patients diagnosed with fungal keratitis at Vissum Alicante.

Methods:

For the diagnosis corneal scrapings were performed. Direct observation techniques as Gram staining and calcofluor white, microbiological cultures in solid and liquid media, and polymerase chain reaction (PCR) were used. DNA amplification and sequencing of the internal transcribed spacer and 5.8S rRNA region from the corneal samples were carried for the detection and molecular identification.

Results:

25 patients were diagnosed of fungal keratitis and 18 (72%) filamentous fungi and 7 (28%) yeasts were found. Four different types of Candida species were founded. The filamentous fungi isolated were 6 (33.3%) Aspergillus, 5 (27.8%) Fusarium, 2 (11.1%) Alternaria, 1 (5.6%) Pyrenochaeta, 1 (5.6%) Scedosporium and 3 (16.6%) could not be identified. A variety of antifungals were used as therapy of this condition. Natamycin, amphotericin B and voriconazole were given topically, while, fluconazole, ketoconazole, and voriconazole were administered orally. New treatment alternatives, such as crosslinking, were used in some patients with good results.

Conclusions:

Fungal keratitis are pathologies difficult of managing. A combination of early diagnosis with a correct administration of treatments are essential to obtain the best results, although often this is not enough and drastic surgical treatments are necessary to eliminate the infection.

Financial Disclosure:

None