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Incidence and clinical characteristics of fungal keratitis in a Danish population from 2000 to 2013.
Acta Ophthalmol 2015; 93(1):54-8AO

Abstract

PURPOSE

Fungal keratitis is a severe sight-threatening condition. The aim of this study was to investigate the incidence and clinical characteristics of fungal keratitis patients living in a temperate climate.

METHODS

By reviewing medical records from 2000 to July 2013, patients with fungal keratitis were identified. Risk factors, clinical signs and outcome were registered.

RESULTS

Twenty-five patients were identified: 52% with Candida, 20% with Fusarium, 16% with Aspergillus and 12% with mixed filamentous fungi. A minimum incidence of fungal keratitis of 0.6 cases per million per year was estimated. Prior topical steroid treatment was commonly found in our cases (44%). Trauma including contact lens wear was associated with infection with filamentous fungi, whereas in patients with Candida infection, ocular surface disease was a prominent feature. Median time from onset of symptoms to diagnosis was 24 days. Only a few patients exhibited classical clinical features such as endothelial plaques (28%), satellite lesions (24%) and feathery edges (16%). The final visual outcome was poor with an average best-corrected logMAR of (mean, 95% CI) 0.70 (0.4-1.0). A total of 52% were treated with corneal transplantation. Patients with Candida infections had a significantly worse visual outcome.

CONCLUSION

We found that patients with fungal keratitis had a poor visual outcome. However, knowledge of risk factors and clinical signs leading to early treatment can improve the prognosis.

Authors+Show Affiliations

Opthalmology Department, University Hospital of Aarhus, Aarhus, Denmark.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24836583

Citation

Nielsen, Stine E., et al. "Incidence and Clinical Characteristics of Fungal Keratitis in a Danish Population From 2000 to 2013." Acta Ophthalmologica, vol. 93, no. 1, 2015, pp. 54-8.
Nielsen SE, Nielsen E, Julian HO, et al. Incidence and clinical characteristics of fungal keratitis in a Danish population from 2000 to 2013. Acta Ophthalmol. 2015;93(1):54-8.
Nielsen, S. E., Nielsen, E., Julian, H. O., Lindegaard, J., Højgaard, K., Ivarsen, A., ... Heegaard, S. (2015). Incidence and clinical characteristics of fungal keratitis in a Danish population from 2000 to 2013. Acta Ophthalmologica, 93(1), pp. 54-8. doi:10.1111/aos.12440.
Nielsen SE, et al. Incidence and Clinical Characteristics of Fungal Keratitis in a Danish Population From 2000 to 2013. Acta Ophthalmol. 2015;93(1):54-8. PubMed PMID: 24836583.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence and clinical characteristics of fungal keratitis in a Danish population from 2000 to 2013. AU - Nielsen,Stine E, AU - Nielsen,Esben, AU - Julian,Hanne Olsen, AU - Lindegaard,Jens, AU - Højgaard,Klavs, AU - Ivarsen,Anders, AU - Hjortdal,Jesper, AU - Heegaard,Steffen, Y1 - 2014/05/19/ PY - 2013/11/28/received PY - 2014/04/11/accepted PY - 2014/5/20/entrez PY - 2014/5/20/pubmed PY - 2015/6/25/medline KW - culture KW - epidemiology KW - fungal keratitis KW - fungus SP - 54 EP - 8 JF - Acta ophthalmologica JO - Acta Ophthalmol VL - 93 IS - 1 N2 - PURPOSE: Fungal keratitis is a severe sight-threatening condition. The aim of this study was to investigate the incidence and clinical characteristics of fungal keratitis patients living in a temperate climate. METHODS: By reviewing medical records from 2000 to July 2013, patients with fungal keratitis were identified. Risk factors, clinical signs and outcome were registered. RESULTS: Twenty-five patients were identified: 52% with Candida, 20% with Fusarium, 16% with Aspergillus and 12% with mixed filamentous fungi. A minimum incidence of fungal keratitis of 0.6 cases per million per year was estimated. Prior topical steroid treatment was commonly found in our cases (44%). Trauma including contact lens wear was associated with infection with filamentous fungi, whereas in patients with Candida infection, ocular surface disease was a prominent feature. Median time from onset of symptoms to diagnosis was 24 days. Only a few patients exhibited classical clinical features such as endothelial plaques (28%), satellite lesions (24%) and feathery edges (16%). The final visual outcome was poor with an average best-corrected logMAR of (mean, 95% CI) 0.70 (0.4-1.0). A total of 52% were treated with corneal transplantation. Patients with Candida infections had a significantly worse visual outcome. CONCLUSION: We found that patients with fungal keratitis had a poor visual outcome. However, knowledge of risk factors and clinical signs leading to early treatment can improve the prognosis. SN - 1755-3768 UR - https://www.unboundmedicine.com/medline/citation/24836583/Incidence_and_clinical_characteristics_of_fungal_keratitis_in_a_Danish_population_from_2000_to_2013_ L2 - https://doi.org/10.1111/aos.12440 DB - PRIME DP - Unbound Medicine ER -