Risk factors for treatment outcome in fungal keratitis.

Abstract

PURPOSE:

To identify risk factors at diagnosis that can serve as prognostic indicators of primary treatment failure in cases of fungal keratitis.

DESIGN:

Prospective, nonrandomized, interventional, comparative study.

PARTICIPANTS:

A total of 115 consecutive patients with fungal keratitis treated at one center during a 6-month period.

METHODS:

Patients with a microscopic corneal ulcer smear that was positive for fungus were enrolled and treated with 5% natamycin monotherapy according to the protocol of the hospital. Treatment responses were assessed at the end of 4 weeks. The prognostic indicators were used in a Poisson model for multiple regression analysis to estimate the relative risk of the main prognostic variables.

MAIN OUTCOME MEASURES:

Response of the ulcer to treatment.

RESULTS:

Of the 115 patients analyzed in the study, 52 (45.2%) were treatment successes, 27 (23.5%) had slow-healing ulcers, and 36 (31.3%) were refractory to primary treatment. Multivariate analysis showed that the predictors of treatment failure were ulcers that exceeded 14 mm(2) (P = 0.009), the presence of hypopyon (P = 0.003), and identification of Aspergillus (P = 0.003).

CONCLUSION:

In patients with fungal keratitis treated with 5% natamycin monotherapy, larger ulcer size and infection with Aspergillus were predictors of a poor outcome.

• Authors: Prajna Lalitha, Namperumalsamy Venkatesh Prajna, Amit Kabra, Kannan Mahadevan, Muthaiah Srinivasan
• Journal: Ophthalmology (Ophthalmology) Vol. 113 Issue 4 Pg. 526-30 (Apr 2006) ISSN: 1549-4713 [Electronic] United States
• PMID: 16581414 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Antifungal Agents
• Natamycin

Topics

• Adolescent
• Adult
• Aged
• Antifungal Agents (therapeutic use)
• Child
• Child, Preschool
• Corneal Ulcer (diagnosis, drug therapy, microbiology)
• Eye Infections, Fungal (diagnosis, drug therapy, microbiology)
• Female
• Fungi (isolation & purification)
• Humans
• Male
• Middle Aged
• Mycoses (diagnosis, drug therapy, microbiology)
• Natamycin (therapeutic use)
• Prospective Studies
• Risk Factors
• Treatment Failure
• Treatment Outcome