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角膜炎:一家三级眼科护理中心5年临床经验的文献综述

keratitis: Review of literature of 5 years' clinical experience at a tertiary eye care center.

作者信息

Vishwakarma Pratima, Bagga Bhupesh

机构信息

The Ramoji Foundation Centre for Ocular Infections and the Cornea Institute, L V Prasad Eye Institute, Hyderabad, India.

出版信息

Semin Ophthalmol. 2023 Feb;38(2):190-200. doi: 10.1080/08820538.2022.2116287. Epub 2022 Aug 29.

Abstract

BACKGROUND

is an important cause of infectious keratitis from tropical and sub-tropical countries. Due to its closely mimicking clinical and microbiological features with fungus, it remained unidentified and managed as fungal keratitis for a long time. Previously all patients had poor outcomes with antifungal therapy and needed surgical treatment with higher rates of recurrences of infection leading to loss of an eye. Thus, a novel approach was required to treat it and, in this article, we would like to elaborate on the drastic change which these 5 years have brought in the management of this condition.

METHODS

In view of making a consolidated article comprising all the required information and also our clinical experience in the management of keratitis, we extensively reviewed several articles available on it over PubMed and Google scholars. Relevant literature describing details about , its clinical correlation, and recent advances from 52 articles including 12 articles from our group were finally included.

RESULTS

Our group identified and highlighted the unique clinical and microbiological features of , performed several studies along with clinical trials, and proposed the strategic way of its diagnosis and treatment. The use of antifungals was replaced with antibacterial medications and this resulted in better medical and surgical outcomes.

CONCLUSION

The diagnosis and management of Pythium insidiosum is constantly evolving with several recent works pointing out the possible changes in the practice patterns for the management of this challenging form of keratitis.

摘要

背景

是热带和亚热带国家感染性角膜炎的重要病因。由于其临床和微生物学特征与真菌极为相似,长期以来一直未被识别,并被当作真菌性角膜炎进行治疗。此前,所有患者接受抗真菌治疗的效果都很差,需要进行手术治疗,且感染复发率较高,导致失明。因此,需要一种新的方法来治疗这种疾病,在本文中,我们将详细阐述这五年间在这种疾病的治疗上所带来的巨大变化。

方法

为了撰写一篇包含所有所需信息以及我们在治疗角膜炎方面临床经验的综合文章,我们在PubMed和谷歌学术上广泛查阅了几篇相关文章。最终纳入了52篇文章(包括我们团队的12篇文章)中描述有关、其临床关联以及最新进展的相关文献。

结果

我们团队识别并突出了的独特临床和微生物学特征,开展了多项研究及临床试验,并提出了其诊断和治疗的策略。抗真菌药物的使用被抗菌药物所取代,这带来了更好的药物和手术治疗效果。

结论

随着近期多项研究指出这种具有挑战性的角膜炎治疗模式可能发生的变化,棘壳孢菌性角膜炎的诊断和治疗也在不断发展。

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