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Clinical, microbiologic, and treatment outcomes of dematiaceous fungal keratitis - A retrospective study

Niruban Ganesan1, Shivananda Narayana2, Joseph Gubert3

  • 1Department of Ophthalmology, JIPMER, Karaikal Campus, Puducherry, India.

Indian Journal of Ophthalmology
|May 21, 2024
PubMed
Abstract

Insights

Dematiaceous fungal keratitis (DFK) is common in South India, affecting older males. Most cases healed with topical treatment, though some required corneal transplants.

Area of Science:

  • Ophthalmology
  • Mycology
  • Infectious Diseases

Background:

  • Dematiaceous fungi are a significant cause of fungal keratitis globally.
  • Limited research exists on dematiaceous fungal keratitis compared to other fungal pathogens.
  • This study focuses on the clinical profile and outcomes of dematiaceous fungal keratitis in South India.

Purpose of the Study:

  • To describe the demographic, clinical, and microbiological characteristics of dematiaceous fungal keratitis (DFK).
  • To evaluate treatment outcomes for DFK in a South Indian referral center.
  • To highlight the incidence and profile of DFK, a less-studied form of fungal keratitis.

Main Methods:

  • An institutional cohort study was conducted over six years at a single ophthalmology center.
  • Culture-proven DFK cases were analyzed for patient demographics, clinical presentation, and microbiological findings.
  • Treatment outcomes, including healing rates and need for therapeutic penetrating keratoplasty (TPK), were assessed over three months.

Main Results:

  • 312 cases of DFK were identified, representing 10% of microbial keratitis and 24.6% of fungal keratitis.
  • The average patient age was 54 years, with a higher prevalence in males (73.4%).
  • Curvularia spp. was the most common isolate (31.7%); 63.5% of cases healed with topical medications, and 79% healed overall, with 21% requiring TPK.

Conclusions:

  • Dematiaceous fungal keratitis presents a significant clinical challenge in South India.
  • The study reports a high incidence of DFK in the region.
  • An excellent healing rate was observed in the treated cohort, suggesting effective management strategies.

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