June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Successful management of Pythium Keratitis: comparative series of 208 cases.
Author Affiliations & Notes
  • Bhupesh Bagga
    L V Prasad Eye Institute, India
  • Savitri Sharma
    L V Prasad, India
  • Anahita Kate
    L V Prasad, India
  • Ashik Mohamed
    L V PRASAD, India
  • Footnotes
    Commercial Relationships   Bhupesh Bagga, None; Savitri Sharma, None; Anahita Kate, None; Ashik Mohamed, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4895. doi:
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      Bhupesh Bagga, Savitri Sharma, Anahita Kate, Ashik Mohamed; Successful management of Pythium Keratitis: comparative series of 208 cases.. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4895.

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

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Abstract

Purpose : To describe the outcome of Pythium keratitis treated with antibiotics and also to compare with that of antifungals.

Methods : Retrospective chart review of cases with microbiologically confirmed Pythium keratitis, seen between 2016 to 2018, was performed. All cases had been treated with topical Linezolid 0.2 % ophthalmic solution and topical Azithromycin eye drop 1% or ointment 1% along with Oral Azithromycin 500 mg (for2 weeks). At every visit, detailed slit lamp examination was done in all patients to look for signs of worsening or improvement. For outcome analysis, the patients, who are lost to follow-up or have received treatment less than 2 weeks, were excluded from the study. The outcome was compared with cases of Pythium Keratitis seen between 2014 to 2016, being managed with antifungals.

Results : Out of 112 (between 2016-2018) patients seen during this period, 69 cases were further analyzed. The mean age of the patients was 38.4±14.7 years. Median visual acuity was logMAR 2.78 (1.20-3.00). Corneal infiltrate was central in 32(46.3%) patients with tentacles (87%). While infection resolved completely on medical therapy in 37(53.6%) patients, 14(20.2%) still needed tectonic penetrating keratoplasty(TPK) due to corneal perforation or thinning inspite of resolving keratitis. Eighteen cases (26.0%) required TPK due to worsening on medical therapy. Out of 96 Cases (between 2014-2016) managed with antifungals, 87 cases (90%), required TPK while with present therapy it reduced to 32(46.4%) cases (p value=<0.0001).

Conclusions : Pythium keratitis can be successfully managed by combination of antibiotics and have better outcome as compared with the use of antifungals.

This is a 2020 ARVO Annual Meeting abstract.

 

Slit lamp image of the microbiologicslly confirmed case of Pythium keratitis (A) which imporved with the current treatment regimen (B) and resulted into scar.

Slit lamp image of the microbiologicslly confirmed case of Pythium keratitis (A) which imporved with the current treatment regimen (B) and resulted into scar.

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