A retrospective study of the spectrum of fungal keratitis in southeastern China.

BACKGROUND

This study investigated the epidemiological characteristics, predisposing factors, clinical features, microbiological findings, and treatment outcomes of patients with fungal keratitis in southeastern China.

METHODS

A retrospective review was carried out on 718 patients diagnosed with fungal keratitis at the the First Affiliated Hospital of Fujian Medical University between January 2004 and December 2017. The sociodemographic data, predisposing factors, clinical details, microbiological findings, and treatment strategies were analyzed.

RESULTS

Fungal keratitis was diagnosed in 718 patients (442 male and 276 female; mean age, 41.4±13.1 years). Most patients came from rural areas (79.7%) and farm work was the main occupational activity (51.7%). Cases were more common during the harvest season between October and December (41.6%). Corneal trauma (73.7%), particularly injury with vegetative matter (51.5%), was the predominant predisposing factor. Corneal scrapings obtained from 621 patients were diagnosed as positive on direct microscopy using a 10% potassium hydroxide (KOH) wet mount preparation. The positive culture rate of corneal scrapings was 89.6%. Fungal isolates were Fusarium species in 444 eyes and Aspergillus species in 98 eyes. Antifungal medications were used to treat 529 patients and 189 patients received surgery.

CONCLUSIONS

Fungal keratitis is a leading cause of infective corneal ulcers in southeastern China. Corneal trauma was the major predisposing factor and direct microscopic examination was a rapid and sensitive method for diagnosis. The species Fusarium was the most common fungal isolate. Antifungal medication was an effective method for treating early and mild cases.