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马来西亚东北部一家 tertiary hospital 的真菌性角膜炎

Mycotic Keratitis in a Tertiary Hospital in Northeastern Malaysia.

机构信息

Universiti Sains Malaysia School of Medical Sciences, Health Campus, Department of Ophthalmology, Kelantan, Malaysia

出版信息

Turk J Ophthalmol. 2020 Dec 29;50(6):332-338. doi: 10.4274/tjo.galenos.2020.57609.

Abstract

OBJECTIVES

To identify the clinical profile, etiology, and outcome of culture-positive mycotic keratitis in a tertiary referral centre in the Northeastern part of Malaysia.

MATERIALS AND METHODS

A retrospective review of all patients with culture-positive mycotic keratitis in Hospital Universiti Sains Malaysia over a 3-year period, from January 2015 to December 2017.

RESULTS

This study included 27 eyes of 27 patients treated for mycotic keratitis based on a positive fungal culture. The most common predisposing factor was ocular trauma, in 22 patients (81.5%). Eleven patients (40.7%) had a presenting visual acuity worse than 6/60, due to central ulcer involvement. Approximately half of these (6 patients) experienced visual improvement post-treatment. spp. was the most common fungus isolated (37%), followed by non-sporulating fungi and spp. Three patients (7.4%) had corneal microperforations, which healed after gluing and bandage contact lens application. One patient (3.7%) required tectonic penetrating keratoplasty and 1 patient (3.7%) underwent evisceration. The final visual acuity was 6/18 or better in approximately half (14 patients) of our cohort and worse than 3/60 in approximately 20% (5 patients).

CONCLUSION

Mycotic keratitis occurred mainly in males and secondary to ocular trauma. The most common organism isolated was spp. Although treatment may improve vision, the visual outcome is guarded.

摘要

目的

确定马来西亚东北部一家三级转诊中心培养阳性真菌性角膜炎的临床特征、病因和结局。

材料和方法

对 2015 年 1 月至 2017 年 12 月期间在马来西亚大学医院治疗的所有培养阳性真菌性角膜炎患者进行回顾性研究。

结果

本研究纳入了 27 例 27 只眼,这些患者均基于真菌培养阳性而接受抗真菌治疗。最常见的致病因素是眼外伤,有 22 例(81.5%)。11 例(40.7%)患者的初始视力低于 6/60,这是由于中央溃疡所致。这些患者中约有一半(6 例)在治疗后视力有所改善。 spp.是最常见的分离真菌(37%),其次是非孢子真菌和 spp.。3 例(7.4%)患者出现角膜微穿孔,在应用粘弹剂和绷带接触镜后愈合。1 例(3.7%)患者需要进行板层角膜移植术,1 例(3.7%)患者需要进行眼球摘除术。我们的队列中,约一半(14 例)患者的最终视力达到或优于 6/18,约 20%(5 例)患者的视力差于 3/60。

结论

真菌性角膜炎主要发生于男性,继发于眼外伤。最常见的分离菌是 spp.。虽然治疗可能会改善视力,但预后仍不乐观。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/439c/7802097/784dd42d26be/TJO-50-332-g1.jpg

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