Ling, Jennifer YM;
Yeung, Sonia N;
Chan, Clara;
Trinh, Tanya;
Antaki, Fares;
Harissi-Dagher, Mona;
Sivachandran, Nirojini;
... Iovieno, Alfonso; + view all
(2024)
Trends and Clinical Outcomes of Fungal Keratitis in Canada: A 20-year Retrospective Multicentre Study.
American Journal of Ophthalmology
, 265
pp. 147-155.
10.1016/j.ajo.2024.04.009.
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Abstract
Purpose: An increase in fungal and particularly filamentous keratitis has been observed in many geographic areas, mostly in contact lens wearers. This study seeks to characterize long-term trends in fungal keratitis in a continental climate area to provide guidance for diagnosis and treatment.// Design: Retrospective multicentric case series.// Methods: Cases of microbiology-confirmed fungal keratitis from 2003 to 2022 presenting to tertiary care centres across Canada were included. Charts were reviewed for patient demographics, risk factors, visual acuity, and treatments undertaken.// Results: A total of 138 patients were identified: 75 had yeast keratitis while 63 had filamentous keratitis. Patients with yeast keratitis had more ocular surface disease (79% vs 28%) while patients with filamentous keratitis wore more refractive contact lenses (78% vs 19%). Candida species accounted for 96% of all yeast identified, while Aspergillus (32%) and Fusarium (26%) were the most common filamentous fungi species. The mean duration of treatment was 81 ± 96 days. Patients with yeast keratitis did not have significantly improved visual acuity with medical treatment (1.8 ± 1 LogMAR to 1.9 ± 1.5 LogMAR, p = 0.9980), in contrast to patients with filamentous keratitis (1.4 ± 1.2 LogMAR to 1.1 ± 1.3 LogMAR, p = 0.0093).// Conclusions: Fungal keratitis is increasing in incidence, with contact lenses emerging as one of the leading risk factors. Significant differences in the risk factors and visual outcomes exist between yeast keratitis and filamentous keratitis which may guide diagnosis and treatment.
| Type: | Article |
|---|---|
| Title: | Trends and Clinical Outcomes of Fungal Keratitis in Canada: A 20-year Retrospective Multicentre Study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ajo.2024.04.009 |
| Publisher version: | https://doi.org/10.1016/j.ajo.2024.04.009 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | infectious keratitis, microbial keratitis, corneal ulcer, fungi, corneal transplant, contact lens, ocular surface disease |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10191342 |
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