June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Epidemiology and treatment outcome of fungal keratitis at Asociación Para Evitar la Ceguera en México, Mexico city
Author Affiliations & Notes
  • Veronica Pamela Urcullo Terrazas
    Cornea, Asociacion Para Evitar la Ceguera en Mexico, Mexico City, Mexico
  • Virginia Vanzzini
    Microbiology, Asociacion Para Evitar la Ceguera en Mexico, Mexico City, Mexico
  • Luis Alberto Aguilar
    Cornea, Asociacion Para Evitar la Ceguera en Mexico, Mexico City, Mexico
  • Francisco Beltran
    Cornea, Asociacion Para Evitar la Ceguera en Mexico, Mexico City, Mexico
  • Everardo Hernandez-Quintela
    Cornea, Asociacion Para Evitar la Ceguera en Mexico, Mexico City, Mexico
  • Footnotes
    Commercial Relationships   Veronica Pamela Urcullo Terrazas, None; Virginia Vanzzini, None; Luis Aguilar, None; Francisco Beltran, None; Everardo Hernandez-Quintela, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4797. doi:
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    • Get Citation

      Veronica Pamela Urcullo Terrazas, Virginia Vanzzini, Luis Alberto Aguilar, Francisco Beltran, Everardo Hernandez-Quintela; Epidemiology and treatment outcome of fungal keratitis at Asociación Para Evitar la Ceguera en México, Mexico city. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4797.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The aim of this review was to report and evaluate the epidemiological characteristics, microbiological diagnosis and treatment outcome of mycotic keratitis at Asociación Para Evitar la Ceguera en México

Methods : A retrospective review of medical and microbiology records was done for all patients with laboratory proven fungal keratitis. We reviewed the records of 100 patients of culture positive fungal keratitis treated from January 2012 to August 2016. Demographics, risk factors, fungal identification, antifungal treatment and clinical outcome were evaluated

Results : The study included 100 eyes. Thirty four patients (34%) were female and 66 were male (66%). The mean age was 48 years, with 53% in the range of 20 to 50 years. Predisposing factors included vegetal ocular trauma (28%), topical steroid use (25%), Diabetes mellitus (25%) and contact lens wear (16%). Identification of fungal elements was achieved by corneal scraping cultures. In 80% the infection was caused by filamentous fungi, and only 20% was caused by yeast. Fusarium was the most commonly isolated agent (40%), with Fusarium solani as the most frequent specie (25%); these followed by Aspergillus spp (16%) and Candida spp (13%). The treatment was medical for 45%, with Natamycin and Voriconazole as the topical antifungals most frequently used. Fifty five patients (55%) required surgical management, with 37% undergoing therapeutic penetrating keratoplasty and 28% conjunctival grafts, 10% ended in evisceration. After a mean follow-up of 6 months, 50% of the patients who presented to the hospital before 20 days from the beginning of the symptoms, had a final vision better than 20/100; in contrast, 82% of the patients who presented after 20 days ended with a vision of 20/400 or worst

Conclusions : We found Fusarium and Aspergillus spp as the most commonly isolated fungi agents. Fungal keratitis was more common in male patients at a productive age (20-50 years), frequently associated to rural environment and vegetal ocular trauma. Other factors often associated with poor prognosis were the use of topical steroids and the presence of Diabetes. The main factor that determined the final outcome was the time between the clinical presentation and the beginning of treatment. Natamicin and Voriconazole are first line treatments, with the use of voriconazole showing better results due to greater penetration and fungus sensibility

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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