Fungal Keratitis In Diabetic Vs Non-Diabetic Patients: A Comparative Analysis Of Clinical Outcomes
Published 2026 - 44th Congress of the ESCRS
Reference: POCOR194 | Type: Free paper | DOI: 10.82333/9syq-rq73
Authors: Dr David Rosário Alves* 1 , Dr Pedro Mota-Moreira 1 , Dr Sofia Machado 1 , Dr Rodrigo Vilares-Morgado 2 , Dr Pedro Neves Cardoso 2 , Prof. Dr João Pinheiro Costa 3 , Prof. Dr Tiago Monteiro 2 , Dr Luís Torrão 2 , Dr Ana Maria Cunha 2
1Ophthalmology,Unidade Local de Saúde de São João,Porto,Portugal, 2Ophthalmology,Unidade Local de Saúde de São João,Porto,Portugal;Surgery and Physiology,Faculty of Medicine, University of Porto,Porto,Portugal, 3Biomedicine,Faculty of Medicine, University of Porto,Porto,Portugal
Purpose
To compare demographic characteristics, clinical presentation, microbiological findings, disease severity, complications, treatment patterns, and outcomes of fungal keratitis between Diabetic (DM) and Non-Diabetic (non-DM) patients.
Setting
Department of Ophthalmology, Unidade Local de Saúde de São João, a tertiary ophthalmic referral centre in Porto, Portugal.
Methods
A retrospective, single-centre, longitudinal study was conducted including 66 eyes from 63 patients (51.5% male) with culture-proven fungal keratitis treated between January 2009 and December 2024. Demographic, clinical, and microbiological characteristics, as well as treatment patterns, complications, and outcomes (BCVA [logMAR], phthisis, need for corneal transplantation, evisceration/enucleation), were compared between eyes of two groups (DM patients and non-DM patients). Univariate analyses were performed using appropriate non-parametric and categorical statistical tests.
Results
Gender distribution, follow-up duration (DM 5.25 vs non-DM 5.04 years, p = 0.504), mean age at diagnosis (DM 70.3 vs non-DM 62.9 years, p=0.051) were similar between groups. Previous corneal transplantation, contact lens use, other ocular pathology, time to hospital presentation, and trauma history didn’t differ significantly. Hypopyon (57.1% vs. 22.2%, p=0.005) and endophthalmitis (19.0% vs. 2.2%, p=0.032) were more frequent in DM. There weren’t significant differences between DM and non-DM regarding baseline (1.5 vs 1.9, p=0.313) and final BCVA (1.9 vs 1.6, p=0.793), fungal class distribution, co-infections, phthisis, or need for PK (15.2% vs 40.9%, p=0.345).
Conclusions
In our cohort, diabetes mellitus was associated with more severe inflammatory and infectious manifestations in fungal keratitis, including higher rates of hypopyon and endophthalmitis. Despite these differences in disease severity, final visual outcomes and surgical requirements were comparable between DM and non-DM patients.