Association of Postfungal Keratitis Corneal Scar Features With Visual Acuity

Area of Science:

• Ophthalmology
• Corneal Disease
• Visual Impairment

Background:

• Corneal opacity is a major cause of global visual impairment.
• Specific features of corneal scars affecting visual acuity remain poorly understood.

Purpose of the Study:

• Identify corneal scar features linked to reduced visual acuity post-fungal keratitis.
• Determine if corneal features can serve as clinical trial outcomes.

Main Methods:

• Prospective cross-sectional study of 71 fungal keratitis patients from the Mycotic Ulcer Treatment Trial I (MUTT I).
• Evaluated best spectacle-corrected visual acuity (BSCVA), contact lens visual acuity, Scheimpflug imaging, and OCT.
• Data collected ~2 years post-enrollment in India.

Main Results:

• BSCVA was most associated with irregular astigmatism and corneal scar density.
• Increased scar density correlated with worse BSCVA.
• Thinnest corneal point best differentiated treatment arms (natamycin vs. voriconazole).

Conclusions:

• Irregular astigmatism and scar density are key factors affecting BSCVA in healed fungal keratitis.
• Thinnest corneal scar point shows potential as a cornea-specific clinical trial outcome.