Agashe Rohan, Radhakrishnan Naveen, Pradhan Sayali, Srinivasan Muthiah, Prajna Venkatesh N, Lalitha Prajna
Department of Cornea and Refractive Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India.
Department of Ocular Microbiology, Aravind Eye Hospital, Madurai, Tamil Nadu, India.
Br J Ophthalmol. 2017 Oct;101(10):1436-1439. doi: 10.1136/bjophthalmol-2016-309845. Epub 2017 Feb 22.
To study the demographic profile, clinical features, treatment outcome and ocular morbidity of smear-positive microsporidial keratoconjunctivitis.
Retrospective case series of all patients with clinical features of microsporidial keratoconjunctivitis and who were smear positive for the same on Gram stain from January 2013 to December 2015. Demographic data, predisposing factors, microbiological investigations, clinical course and visual outcome were analysed.
Of the 10 655 patients with conjunctivitis, 550 (5.2%) patients were positive for microsporidia on Gram stain during this time period. The disease was prevalent throughout the year with an increased incidence from July to December. Bilateral involvement was seen in 27 (4.9%) patients. There was no predisposing risk factor in 428 (77.8%) patients. 384 (69.1%) patients had received prior treatment before presentation to us with the most common drug being antibiotic in 285 (49.4%) patients. All the patients underwent diagnostic corneal debridement and received topical 0.3% fluconazole eye drops four times a day. Of the 296 patients who followed-up, 187 (63.1%) patients had complete resolution without sequelae. 68 (22.9%) had persistent superficial punctate keratopathy, 30 (10.1%) developed subepithelial nummular keratitis. No significant change in visual acuity was seen in 255 (80.7%) eyes, two or more line improvement was seen in 48 (15.2%) eyes, while two or more line worsening was seen in 13 (4.1%) eyes.
Microsporidial keratoconjunctivitis is prevalent in South India throughout the year. The characteristic clinical signs and simple microbiological investigation help us to differentiate it from adenoviral keratoconjunctivitis. The visual prognosis is good.
研究涂片阳性的微孢子虫性角膜结膜炎的人口统计学特征、临床特征、治疗效果及眼部发病率。
对2013年1月至2015年12月期间所有具有微孢子虫性角膜结膜炎临床特征且革兰染色涂片呈阳性的患者进行回顾性病例系列研究。分析人口统计学数据、诱发因素、微生物学检查、临床病程及视力转归。
在10655例结膜炎患者中，在此期间有550例（5.2%）患者革兰染色微孢子虫呈阳性。该病全年均有发生，7月至12月发病率升高。27例（4.9%）患者为双侧受累。428例（77.8%）患者无诱发危险因素。384例（69.1%）患者在前来就诊前曾接受过治疗，其中最常见的药物是抗生素，有285例（49.4%）患者使用过。所有患者均接受了诊断性角膜清创术，并每天4次使用0.3%氟康唑滴眼液。在296例进行随访的患者中，187例（63.1%）患者完全治愈且无后遗症。68例（22.9%）患者持续性浅层点状角膜炎，30例（10.1%）患者发生上皮下钱币状角膜炎。255只眼（80.7%）视力无明显变化，48只眼（15.2%）视力提高两行或更多，13只眼（4.1%）视力下降两行或更多。
微孢子虫性角膜结膜炎在印度南部全年均有发生。其特征性临床体征及简单的微生物学检查有助于将其与腺病毒性角膜结膜炎相鉴别。视力预后良好。
