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Management Algorithm for Fungal Keratitis: The TST (Topical, Systemic, and Targeted Therapy) Protocol
Namrata Sharma1, Pranita Sahay, Prafulla K Maharana
1Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Cornea
|October 19, 2018
Summary
The topical, systemic, and targeted therapy (TST) protocol effectively managed fungal keratitis in 79.8% of patients. This stepwise approach offers a structured algorithm for treating fungal eye infections of varying severity.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Fungal keratitis is a serious eye infection that can lead to vision loss.
- Effective management strategies are crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of the topical, systemic, and targeted therapy (TST) protocol in managing fungal keratitis.
- To establish a stepwise treatment algorithm for fungal keratitis.
Main Methods:
- A cohort of 223 treatment-naive fungal keratitis cases were analyzed.
- The TST protocol involved a stepwise approach using topical, oral, and intrastromal/intracameral antifungals.
- Surgical intervention (penetrating keratoplasty) was reserved for refractory cases.
Main Results:
- The TST protocol achieved a 79.8% success rate in treating fungal keratitis.
- Mean healing time was 41.5 days, with significant visual acuity improvement.
- Fusarium and Aspergillus were the most common causative agents.
Conclusions:
- The TST protocol provides a structured and effective stepwise treatment algorithm for fungal keratitis.
- This approach can be adapted for fungal keratitis of varying severity.
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