Abstract:
PURPOSE:To describe the clinical characteristics, diagnosis, treatment, and visual outcome of 61 cases of Fusarium keratitis in Mexico. METHODS:Retrospective, comparative study of 61 patients with clinically and culture-confirmed Fusarium keratitis, who were attended at an eye hospital in Mexico City from 1981 to 2001. RESULTS:Fusarium solani was the main causal agent in 83.6% of cases. Trauma history was observed in 57.4% and a history of agricultural activity in 34.4%. Signs were redness (100%), epithelial defects (98.3%), superficial corneal ulcer (95.1%), anterior chamber inflammation (91.8%), and satellite infiltrates (75.4%). In 50% of cases, the treatment was topical ketoconazole 2%; in 34.2% of cases, additional topical antifungal preparations were used. A total of 77% of patients improved and 23% worsened. Conjunctival flap was indicated in 4 of 61 patients (6.5%), and 14 of 61 patients (23%) underwent penetrating keratoplasty. Two of 61 patients were treated with tectonic keratoplasty. Evisceration surgeries were practiced in 14 of 61 patients (22.9%). The final visual acuity after medical or medical/surgical therapy, was no light perception (NLP) in 19 patients (33.33%), light perception (LP) to hand movements (HM) in 18 patients (31.57%), 20/400 to 20/200 in 1 patient (1.75%), 20/150 to 20/60 in 5 patients (8.77%), and 20/40 to 20/20 in 14 patients (24.56%). Four patients were lost to follow-up. CONCLUSIONS:Fusarium is the most common cause of fungal keratitis in Mexico. Most cases (43/54, 79.6%) improved with topical antifungal therapy (either monotherapy or combined). We suggest surgical therapy with conjunctival flap or penetrating keratoplasty in advanced cases, when there has been poor response to medical therapy or a very low final visual acuity.
journal_name
Corneajournal_title
Corneaauthors
Pérez-Balbuena AL,Vanzzini-Rosano V,Valadéz-Virgen Jde J,Campos-Möller Xdoi
10.1097/ICO.0b013e31819bc2easubject
Has Abstractpub_date
2009-07-01 00:00:00pages
626-30issue
6eissn
0277-3740issn
1536-4798journal_volume
28pub_type
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