Treatment Strategies for Filamentous Fungi Keratitis

Area of Science:

• Ophthalmology
• Mycology
• Infectious Diseases

Background:

• Filamentous fungi keratitis is a serious ocular infection.
• Accurate diagnosis and timely treatment are crucial for visual outcomes.
• Understanding epidemiology and treatment efficacy is vital for clinical practice.

Purpose of the Study:

• To describe clinical findings, epidemiology, and treatment outcomes of filamentous fungi keratitis.
• To compare the efficacy of different antifungal treatments.
• To evaluate the effect of additive topical steroids in managing fungal keratitis.

Main Methods:

• Retrospective study of 25 eyes with filamentous fungi keratitis over 7 years (2013-2020).
• Data collected included best-corrected visual acuity (BCVA), clinical signs, symptoms, risk factors, and outcomes.
• Analysis of antifungal treatments, including topical natamycin 5% and voriconazole 2%, and use of topical steroids.

Main Results:

• 68% of eyes showed improvement in BCVA.
• Mean BCVA improved from 0.75 to 0.48 logMAR.
• Topical natamycin 5% and voriconazole 2% combination was the most frequent treatment (44%).
• Topical steroids were used in 52% of cases, and penetrating keratoplasty in 16%.

Conclusions:

• Filamentous fungi keratitis diagnosis is often delayed, impacting outcomes.
• High antifungal resistance contributes to poor treatment results.
• Access to topical natamycin 5% appears associated with favorable outcomes in fungal keratitis.