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Hypopyon in patients with fungal keratitis.
Chin Med J (Engl) 2012; 125(3):470-5CM

Abstract

BACKGROUND

Hypopyon is common in eyes with fungal keratitis. The evaluation of the clinical features, culture results and the risk factors for hypopyon and of the possible correlation between hypopyon and the treatment outcome could be helpful for making treatment decisions.

METHODS

The medical records of 1066 inpatients (1069 eyes) with fungal keratitis seen at the Shandong Eye Institute from January 2000 to December 2009 were reviewed retrospectively for demographic features, risk factors, clinical characteristics, laboratory findings and treatment outcomes. The incidence of hypopyon, the fungal culture positivity for hypopyon, risk factors for hypopyon and the effect of hypopyon on the treatment and prognosis were determined.

RESULTS

We identified 1069 eyes with fungal keratitis. Of the 850 fungal culture-positive eyes, the Fusarium species was the most frequent (73.6%), followed by Alternaria (10.0%) and Aspergillus (9.0%). Upon admission, 562 (52.6%) eyes with hypopyon were identified. The hypopyon of 66 eyes was evaluated via fungal culturing, and 31 eyes (47.0%) were positive. A total of 194 eyes had ocular hypertension, and 172 (88.7%) of these eyes had hypopyon (P < 0.001). Risk factors for incident hypopyon included long duration of symptoms (P < 0.001), large lesion size (P < 0.001) and infection caused by the Fusarium and Aspergillus species (P < 0.001). The positivity of fungal culture for hypopyon was associated with duration of symptoms and lesion size. Surgical intervention was more common in cases with hypopyon (P < 0.001). Hypopyon was a risk factor for the recurrence of fungal keratitis after corneal transplantation (P = 0.002).

CONCLUSIONS

Hypopyon is common in patients with severe fungal keratitis and can cause ocular hypertension. About half of the hypopyon cases were positive based on fungal culture. Long duration of symptoms, large lesion size and infection with the Fusarium and Aspergillus species were risk factors for hypopyon. The presence of hypopyon increases the likelihood of surgical intervention.

Authors+Show Affiliations

Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22490405

Citation

Xu, Ling-Juan, et al. "Hypopyon in Patients With Fungal Keratitis." Chinese Medical Journal, vol. 125, no. 3, 2012, pp. 470-5.
Xu LJ, Song XS, Zhao J, et al. Hypopyon in patients with fungal keratitis. Chin Med J. 2012;125(3):470-5.
Xu, L. J., Song, X. S., Zhao, J., Sun, S. Y., & Xie, L. X. (2012). Hypopyon in patients with fungal keratitis. Chinese Medical Journal, 125(3), pp. 470-5.
Xu LJ, et al. Hypopyon in Patients With Fungal Keratitis. Chin Med J. 2012;125(3):470-5. PubMed PMID: 22490405.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hypopyon in patients with fungal keratitis. AU - Xu,Ling-Juan, AU - Song,Xiu-Sheng, AU - Zhao,Jing, AU - Sun,Shi-Ying, AU - Xie,Li-Xin, PY - 2012/4/12/entrez PY - 2012/4/12/pubmed PY - 2012/8/4/medline SP - 470 EP - 5 JF - Chinese medical journal JO - Chin. Med. J. VL - 125 IS - 3 N2 - BACKGROUND: Hypopyon is common in eyes with fungal keratitis. The evaluation of the clinical features, culture results and the risk factors for hypopyon and of the possible correlation between hypopyon and the treatment outcome could be helpful for making treatment decisions. METHODS: The medical records of 1066 inpatients (1069 eyes) with fungal keratitis seen at the Shandong Eye Institute from January 2000 to December 2009 were reviewed retrospectively for demographic features, risk factors, clinical characteristics, laboratory findings and treatment outcomes. The incidence of hypopyon, the fungal culture positivity for hypopyon, risk factors for hypopyon and the effect of hypopyon on the treatment and prognosis were determined. RESULTS: We identified 1069 eyes with fungal keratitis. Of the 850 fungal culture-positive eyes, the Fusarium species was the most frequent (73.6%), followed by Alternaria (10.0%) and Aspergillus (9.0%). Upon admission, 562 (52.6%) eyes with hypopyon were identified. The hypopyon of 66 eyes was evaluated via fungal culturing, and 31 eyes (47.0%) were positive. A total of 194 eyes had ocular hypertension, and 172 (88.7%) of these eyes had hypopyon (P < 0.001). Risk factors for incident hypopyon included long duration of symptoms (P < 0.001), large lesion size (P < 0.001) and infection caused by the Fusarium and Aspergillus species (P < 0.001). The positivity of fungal culture for hypopyon was associated with duration of symptoms and lesion size. Surgical intervention was more common in cases with hypopyon (P < 0.001). Hypopyon was a risk factor for the recurrence of fungal keratitis after corneal transplantation (P = 0.002). CONCLUSIONS: Hypopyon is common in patients with severe fungal keratitis and can cause ocular hypertension. About half of the hypopyon cases were positive based on fungal culture. Long duration of symptoms, large lesion size and infection with the Fusarium and Aspergillus species were risk factors for hypopyon. The presence of hypopyon increases the likelihood of surgical intervention. SN - 0366-6999 UR - https://www.unboundmedicine.com/medline/citation/22490405/Hypopyon_in_patients_with_fungal_keratitis_ L2 - http://Insights.ovid.com/pubmed?pmid=22490405 DB - PRIME DP - Unbound Medicine ER -