CLINICAL PRESENTATION AND OUTCOMES OF CULTURE-PROVEN FUNGAL KERATITIS: A RETROSPECTIVE COMPARISON STUDY BETWEEN FILAMENTOUS AND YEAST FUNGI

Published 2022 - 26th ESCRS Winter Meeting

Reference: FP77 | Type: Abstracts | DOI: 10.82333/9hfg-m412

Authors: Rosa Pinheiro* ¹ , Patrícia Conde ² , João Gil ² , Esmeralda Costa ¹ , Andreia Rosa ³ , Maria João Quadrado ⁴ , Joaquim Murta ³

¹Ophthalmology Unit,Centro Hospitalar e Universitário de Coimbra,Coimbra,Portugal, ²Ophthalmology unit,Centro Hospitalar e Universitário de Coimbra,Coimbra,Portugal, ³Ophthalmology Unit,Centro Hospitalar e Universitário de Coimbra,Coimbra,Portugal;Clinical academic center of Coimbra,Centro Hospitalar e Universitário de Coimbra,Coimbra,Portugal;University Clinic of Ophthalmology,Faculty of Medicine, University of Coimbra,Coimbra,Portugal, ⁴Ophthalmology Unit,Centro Hospitalar e Universitário de Coimbra,Coimbra,Portugal;University Clinic of Ophthalmology,Faculty of Medicine, University of Coimbra,Coimbra,Portugal;Clinical academic center of Coimbra,Centro Hospitalar e Universitário de Coimbra,Coimbra,Portugal

Purpose

To compare risk factors, clinical features, and management outcomes of culture-proven filamentous and yeast fungal keratitis.

Setting

Retrospective comparison study from Coimbra University Hospital, in Coimbra, Portugal.

Methods

We identified all cases of fungal keratitis from the microbiologic records between 2005 and 2020 at the Coimbra University Hospital, in Portugal. Demographic data, risk factors, logMAR visual acuity (VA), therapeutic management and functional outcomes were noted. We compared clinical characteristics and treatment outcomes between filamentous (group 1) and yeast (group 2) fungi.

Results

Of the 49 eyes of 49 patients (mean age 59.24 ± 27.8 years) with fungal keratitis, 33 had a filamentous fungus (group 1) and 16 had a yeast fungus (group 2). Patients with filamentous fungi had significantly better VA at presentation (mean VA 1.52 ± 1.02 logMAR in group 1, versus 2.15 ± 0.60 logMAR in group 2; p=0.042) and eyes with yeast fungi had a greater VA improvement following treatment (-0.32 ± 0,73 logMAR in group 2, versus -1.33 ± 1.32 logMAR in group 1; p=0.007). No correlations were found between filamentous and yeast fungi and contact lens use, history of trauma or surgery, corneal perforation, and previous penetrating keratoplasty. Initiation of antifungal therapy within 72 hours of clinical onset was associated with a greater VA improvement (p=0.048).

Conclusion

In this analysis, eyes with yeast fungal keratitis had better clinical outcomes than eyes with filamentous keratitis. Commencement of antifungal therapy within 72 hours of clinical onset was associated with greater VA improvement.