1999 年至 2008 年真菌性角膜炎的研究进展。

Update on fungal keratitis from 1999 to 2008.

机构信息

Cornea Service, Wills Eye Institute, Department of Ophthalmology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

出版信息

Cornea. 2010 Dec;29(12):1406-11. doi: 10.1097/ICO.0b013e3181da571b.

DOI:10.1097/ICO.0b013e3181da571b

PMID:20847685

Abstract

PURPOSE

To report trends in fungal keratitis from a single institution between 1999 and 2008.

METHODS

Retrospective chart review of the patients presenting to the cornea service with fungal keratitis from April 1999 to December 2008.

RESULTS

Seventy-eight eyes of 76 patients were identified. The most common predisposing factors included contact lens use (35.9%), trauma (21.8%), and history of penetrating keratoplasty (15.4%). There was a significant increase in the rate of contact lens-related Fusarium infections over time, which peaked in 2005 and 2006 (P = 0.021). Almost 40% of fungal keratitis cases [11 of 28 eyes (39.3%)] were soft contact lens-related Fusarium infections in 2005 and 2006, and this decreased to less than 10% [2 of 25 eyes (8%)] in 2007 and 2008. The odds of having a contact lens-related Fusarium infection in 2005-2006 compared with 2007-2008 was 4.40 (95% confidence interval of 0.60-32.50) (P = 0.178). Despite the decrease in contact lens-related Fusarium infections, the number of fungal infections remained elevated in 2007 (10 eyes) and 2008 (14 eyes), including contact lens-related infections (3 in 2007 and 6 in 2008).

CONCLUSIONS

A definite increase in the number of fungal keratitis cases began in 2004 and continued through 2006 during the Fusarium outbreak associated with ReNu with MoistureLoc. Despite the decrease in contact lens-related Fusarium infections, the overall number of fungal keratitis cases remained high through 2008. Fungal keratitis was more often associated with contact lens use than with trauma in this time.

摘要

目的

报告 1999 年至 2008 年间某单一机构真菌性角膜炎的趋势。

方法

对 1999 年 4 月至 2008 年 12 月期间因真菌性角膜炎就诊于角膜科的患者进行回顾性图表审查。

结果

共确定了 76 例 78 只眼的患者。最常见的诱发因素包括接触镜使用（35.9%）、外伤（21.8%）和穿透性角膜移植史（15.4%）。接触镜相关镰刀菌感染的发生率随时间显著增加，在 2005 年和 2006 年达到高峰（P=0.021）。在 2005 年和 2006 年，近 40%的真菌性角膜炎病例[28 只眼中的 11 只（39.3%）]与软性接触镜相关的镰刀菌感染有关，而在 2007 年和 2008 年，这一比例降至 25 只眼中的 2 只（8%）。与 2007-2008 年相比，2005-2006 年接触镜相关镰刀菌感染的几率为 4.40（95%置信区间为 0.60-32.50）（P=0.178）。尽管接触镜相关镰刀菌感染有所减少，但 2007 年（10 只眼）和 2008 年（14 只眼）的真菌感染数量仍居高不下，包括接触镜相关感染（2007 年 3 例，2008 年 6 例）。