Clinical Characteristics and Outcomes of Fungal Keratitis in the United Kingdom 2011–2020: A 10-Year Study

Fungal keratitis (FK) is a serious ocular infection that often poses significant diagnostic and therapeutic dilemmas. This study aimed to examine the causes, clinical characteristics, outcomes, and prognostic factors of FK in the UK. All culture-positive and culture-negative presumed FK (with comple...

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Bibliographic Details
Published in:Journal of fungi (Basel) 2021-11, Vol.7 (11), p.966
Main Authors: Ting, Darren Shu Jeng, Galal, Mohamed, Kulkarni, Bina, Elalfy, Mohamed S., Lake, Damian, Hamada, Samer, Said, Dalia G., Dua, Harminder S.
Format: Article
Language:English
Subjects:
Acuity
Bacterial infections
Candida
contact lens
Cornea
corneal infection
Corneal transplantation
corneal ulcer
Disease
fungal infection
Fungi
Fusarium
Hospitals
Immunosuppression
Infections
Keratitis
Medical innovations
Medical prognosis
Microscopy
Patients
Risk factors
Statistical analysis
Ulcers
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Summary:Fungal keratitis (FK) is a serious ocular infection that often poses significant diagnostic and therapeutic dilemmas. This study aimed to examine the causes, clinical characteristics, outcomes, and prognostic factors of FK in the UK. All culture-positive and culture-negative presumed FK (with complete data) that presented to Queen’s Medical Centre, Nottingham, and the Queen Victoria Hospital, East Grinstead, between 2011 and 2020 were included. We included 117 patients (n = 117 eyes) with FK in this study. The mean age was 59.0 ± 19.6 years (range, 4–92 years) and 51.3% of patients were female. Fifty-three fungal isolates were identified from 52 (44.4%) culture-positive cases, with Candida spp. (33, 62.3%), Fusarium spp. (9, 17.0%), and Aspergillus spp. (5, 9.4%) being the most common organisms. Ocular surface disease (60, 51.3%), prior corneal surgery (44, 37.6%), and systemic immunosuppression (42, 35.9%) were the three most common risk factors. Hospitalisation for intensive treatment was required for 95 (81.2%) patients, with a duration of 18.9 ± 16.3 days. Sixty-six (56.4%) patients required additional surgical interventions for eradicating the infection. Emergency therapeutic/tectonic keratoplasty was performed in 29 (24.8%) cases, though 13 (44.8%) of them failed at final follow-up. The final corrected-distance-visual-acuity (CDVA) was 1.67 ± 1.08 logMAR. Multivariable logistic regression analyses demonstrated increased age, large infiltrate size (>3 mm), and poor presenting CDVA (
ISSN:2309-608X
2309-608X
DOI:10.3390/jof7110966