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Curvularia keratitis.

K R Wilhelmus1, D B Jones

  • 1Sid W. Richardson Ocular Microbiology Laboratory, Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA.

Transactions of the American Ophthalmological Society
|January 19, 2002
PubMed
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Curvularia keratitis, often linked to plant trauma, presents with feathery corneal infiltrates. Topical natamycin effectively treats this fungal infection, leading to good visual outcomes in most cases.

Area of Science:

  • Ophthalmology
  • Medical Mycology
  • Infectious Diseases

Background:

  • Curvularia keratitis is a form of corneal phaeohyphomycosis.
  • Risk factors and clinical presentation require further elucidation for effective management.

Purpose of the Study:

  • To identify risk factors and clinical signs of Curvularia keratitis.
  • To evaluate the management strategies and outcomes for this condition.

Main Methods:

  • Retrospective review of 43 culture-proven Curvularia keratitis cases (1970-1999).
  • Analysis of clinical data, laboratory records, and in vitro susceptibility to topical natamycin.
  • Descriptive statistics and regression models to assess treatment duration and visual outcomes.

Main Results:

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  • Trauma, often plant-related, was a key risk factor, with 69% of cases occurring during summer months.
  • Clinical signs ranged from feathery infiltrates to suppurative ulcers; hypopyon indicated increased complication risk.
  • Topical natamycin demonstrated excellent in vitro activity and clinical efficacy, with 78% of patients achieving 20/40 or better vision.

Conclusions:

  • Curvularia keratitis typically presents as feathery corneal infiltrates, progressing to suppurative lesions.
  • Early diagnosis and treatment with topical natamycin are crucial for favorable visual outcomes.
  • Surgical interventions like lamellar or penetrating keratoplasty are reserved for severe complications.