Clinical Patterns Of Fungal Keratitis At Moorfields Eye Hospital: A 10-Year Observational Longitudinal Study (2013-2023)
Published 2025 - 43rd Congress of the ESCRS
Reference: FP23.02 | Type: Free paper | DOI: 10.82333/nyjf-2847
Authors: Ruth K Jones* 1 , Stephen Winder 1
1Sheffield Teaching Hospitals,Sheffield,United Kingdom
Purpose
To review trends of fungal keratitis (FK) at a tertiary ophthalmic referral unit over a 10-year period (2013-2023)
Setting
Cornea and External Disease Department in Moorfields Eye Hospital, United Kingdom
Methods
All cases of FK presenting to Moorfields Eye Hospital (2013-2023) were identified retrospectively. Diagnosis of FK was based on a positive corneal culture, polymerase chain reaction (PCR), corneal biopsy or in vivo confocal microscopy (IVCM). In the absence of positive investigations, a clinical diagnosis of FK was made if atypical features were present, such as an infiltrate with feathery borders or satellite lesions and no response to antibacterial therapy.
Medical records were reviewed to determine patient demographics, risk factors, visual acuity, clinical features and treatments undertaken.
Results
177 cases (42% male) were identified (median age: 60.5 years). Filamentous fungi were identified in 20.9% (37/177), yeasts in 37.3% (66/177) and mixed in 1%. Positive cultures were obtained in 38% (68/177); of these 43 (63%) were yeasts and 24 (35%) filamentary. We had a positive PCR in 13% (23/177) and a positive IVCM in 26% (46/177). No fungus could be isolated in 70 (39.5%), with diagnosis made on clinical findings alone.
Contact lens use was the most common risk factor for filamentary FK (53.3%, 16/30), whilst ocular surface disease (42%, 21/50) and steroid use (71%) were the most common risk factors for yeasts. 49.3% of cases had their vision decreased to 6/60 or worse and penetrating keratoplasty was required in 39% (69/177).
Conclusions
Yeasts are responsible for most cases of FK as opposed to our previous study which reported filamentary as the most common cause of FK at our centre (2007-2014). The increasing number of ocular surface disease related cases referred to our clinic might be the cause for this change in the trend of FK. Similarly to our previous study, contact lens wearing remains the most common risk factor for filamentary FK.