Recent trends: Medical management of infectious keratitis

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Infectious keratitis remains a significant cause of vision loss.
• Traditional treatments for bacterial keratitis often involve fortified antibiotics.
• Management of fungal and viral keratitis presents unique challenges.

Purpose of the Study:

• To review recent advancements in the diagnosis of infectious keratitis.
• To highlight novel therapeutic approaches for various forms of infectious keratitis.
• To discuss emerging treatment options for refractory cases.

Main Methods:

• A comprehensive literature search of Medline up to March 2014 was performed.
• Relevant studies were selected from international indexed journals.
• Key search terms included infectious keratitis, diagnostic modalities, and treatment approaches.

Main Results:

• Specular microscopy and polymerase chain reaction (PCR) show promise for diagnosing infectious keratitis, particularly in refractory cases.
• Fourth-generation fluoroquinolones offer effective monotherapy for bacterial keratitis.
• Corneal collagen cross-linking is emerging as a treatment for refractory cases.
• Newer antifungal agents like voriconazole and novel administration routes (intracameral, intrastromal) demonstrate positive responses.
• Ganciclovir shows promise for herpes simplex keratitis.

Conclusions:

• Advancements in diagnostic techniques, including specular microscopy and PCR, are crucial for infectious keratitis.
• Emerging treatments like fourth-generation fluoroquinolones, voriconazole, and corneal collagen cross-linking offer improved outcomes.
• A combination of newer diagnostics and therapeutics is transforming infectious keratitis management.