Department of Ophthalmology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Department of Ophthalmology, Fujian Medical University Union Hospital, Fuzhou, China.
Ann Palliat Med. 2021 Sep;10(9):9480-9487. doi: 10.21037/apm-21-1949.
This study investigated the epidemiological characteristics, predisposing factors, clinical features, microbiological findings, and treatment outcomes of patients with fungal keratitis in southeastern China.
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.
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.
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.
本研究调查了中国东南部真菌性角膜炎患者的流行病学特征、易患因素、临床特征、微生物学发现和治疗结果。
对 2004 年 1 月至 2017 年 12 月在福建医科大学附属第一医院诊断为真菌性角膜炎的 718 例患者进行回顾性分析。分析了社会人口统计学数据、易患因素、临床细节、微生物学发现和治疗策略。
诊断为真菌性角膜炎的 718 例患者中，男性 442 例，女性 276 例，平均年龄（41.4±13.1）岁。大多数患者来自农村地区（79.7%），主要职业活动是务农（51.7%）。发病高峰期为 10 月至 12 月的收获季节（41.6%）。角膜创伤（73.7%），特别是带植物性物质的损伤（51.5%）是主要的易患因素。621 例患者的角膜刮片直接镜检用 10%氢氧化钾（KOH）湿片检查，诊断为阳性。角膜刮片的阳性培养率为 89.6%。真菌分离株中 444 眼为镰孢菌属，98 眼为曲霉菌属。529 例患者使用抗真菌药物治疗，189 例患者接受手术治疗。
真菌性角膜炎是中国东南部感染性角膜溃疡的主要原因。角膜创伤是主要的易患因素，直接显微镜检查是一种快速而敏感的诊断方法。最常见的真菌分离株为镰孢菌属。抗真菌药物是治疗早期和轻度病例的有效方法。
