Department of Cornea and Anterior Segment Services, C L Gupta Eye Institute, Moradabad, Uttar Pradesh, India.
Department of Clinical and Public Health Research, C L Gupta Eye Institute, Moradabad, Uttar Pradesh, India.
Indian J Ophthalmol. 2022 Mar;70(3):852-859. doi: 10.4103/ijo.IJO_999_21.
To determine the seasonality, clinical profile, and treatment outcome of Fusarium keratitis.
A retrospective medical chart review of 97 patients with culture-proven Fusarium keratitis at a tertiary eye care institution from January 2018 to December 2019.
The median (SD) age at enrollment was 44.6 (16) years; 75 (79.8%) of them were male. Presence of infiltrate less than 4 mm at baseline indicated 4.4 times the odds of achieving final BCVA more than 20/60 (95% CI: 1.4-13.3; P=0.008). The absence of surgical management indicated 8.1 times the odds of achieving final BCVA of more than 20/60 (95% CI: 0.9-71.5; P = 0.06). The visual acuity at presentation, duration between symptoms and presentation, history of ocular trauma, previous use of topical medications, and presence of hypopyon were not identified as significant predictors of final BCVA in the multivariable regression analysis.
Smaller infiltrate size and absence of surgical management are the significant predictors of good visual outcome. Visual outcome of Fusarium keratitis is poor, and a significant number of patients did not respond to anti-fungal therapy and had to undergo surgeries. To the best of our knowledge, this is the largest case series on Fusarium keratitis to date.
确定镰刀菌角膜炎的季节性、临床特征和治疗结果。
对 2018 年 1 月至 2019 年 12 月在一家三级眼科医疗机构进行的 97 例经培养证实为镰刀菌角膜炎患者的病历进行回顾性医学图表审查。
入组时的中位（SD）年龄为 44.6（16）岁；其中 75 人（79.8%）为男性。基线时浸润小于 4mm 表明最终视力优于 20/60 的可能性增加 4.4 倍（95%CI：1.4-13.3；P=0.008）。没有手术治疗表明最终视力优于 20/60 的可能性增加 8.1 倍（95%CI：0.9-71.5；P=0.06）。多变量回归分析并未发现就诊时视力、症状出现至就诊时间、眼部外伤史、局部用药史和前房积脓等因素是最终视力的显著预测因素。
较小的浸润面积和无手术治疗是良好视力结果的显著预测因素。镰刀菌角膜炎的预后较差，相当数量的患者对抗真菌治疗无反应，不得不进行手术。据我们所知，这是迄今为止关于镰刀菌角膜炎的最大病例系列。
