Delhi Journal of Ophthalmology

Risk Factors and Treatment Outcomes of Fungal Keratitis : A Tertiary Eye Care Centre Experience

Pradnya K Bhole, Dipali P Parmar, Nikita P Goel

Department of Ophthalmology, M and J Institute of Ophthalmology, Government Eye Hospital, Ahmedabad, India

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.


Corresponding Author:

Pradnya K Bhole
Assistant Professor, Ophthalmology 
M and J Institute of Ophthalmology, Government Eye Hospital, Ahmedabad, India
Email: dr.pradnya.bhole@gmail.com


Received: 09-JUN-2020 Accepted: 30-SEP-2020 Published Online: 09-JUL-2021
DOI: https://dx.doi.org/10.7869/djo.655

Abstract
Purpose: To study the epidemiological characteristics, microbiological diagnosis and treatment outcome of fungal keratitis in a tertiary eye care centre of Western India 

Materials and Methods: A retrospective non-comparative observational review of the medical and microbiological records was done for all the patients with laboratory proven fungal keratitis on 10% KOH wet mount. Data was compiled in Microsoft Office Excel 2010 spreadsheet and analysis was done using Med-Calc software. Chi square test was used for categorical data.

Results: Between July 2016 to August 2018, 104/354 (29.3 %)corneal scrapings of microbial keratitis showed presence of fungal mycelia on 10% KOH wet mount. 72/104 patients were included in the study. Vegetative trauma (31/72 eyes, 43.06%) was the commonest risk factor. Aspergillus and Fusarium species were the major fungi isolated. 52/72 (72.2%) eyes healed with a scar, of which 21 (40.38%) healed with medical management alone, 29 (55.77%) needed additional tissue adhesive with bandage contact lens (BCL) and 2(3.85%) required intracameral Voriconazole. 334/52 eyes had a mean duration of presentation<=10 days (p<0.001)  the need of keratoplasty (15/72) was seen in significantly larger number of patients presenting late (>10 days) (p<0.05).

Conclusion: History of late presentation, large extent of keratitis and presence of thinning/perforation at presentation were associated with the need for keratoplasty. Considering the recalcitrant course of fungal keratitis, the severity and time of presentation is highly predictive of the disease treatment and outcome.

Keywords :Fungal, Koh, Trauma, Keratoplasty, Treatment Outcome