Original Article

Cytologically Diagnosed Fungal Keratitis: Clinical Features and Treatment Results

10.4274/tjo.40.255

  • Hande T. Sekeroğlu
  • Kemal Yar
  • Elif Damar
  • Aysun Uğuz
  • Meltem Yağmur
  • T. Reha Ersöz
  • Filiz Kibar

Received Date: 14.03.2010 Accepted Date: 07.06.2010 Turk J Ophthalmol 2010;40(5):255-259

Purpose:

To report the clinical and laboratory findings and treatment results of fungal keratitis.

Material and Method:

Patient demographics, clinical and laboratory findings, and treatment outcomes of 20 cases of fungal keratitis diagnosed and treated from October 2004 through October 2007 were reviewed. Corneal scrapings and cultures were taken from ulcer beds and edges for microscopic evaluation. All of the patients were treated with topical amphotericin B, natamycin and systemic ketoconazole.

Results:

Eleven patients had trauma history. All corneal scrapings revealed fungal hyphae. Fungal growth occurred in the cultures of two patients: Aspergillus sp. and Fusarium sp. The mean duration of antifungal treatment was 8.7±4.53 (3-20) weeks. Amniotic membrane transplantation was performed in three out of 20 patients because of severe corneal thinning. One patient required penetrating keratoplasty for sight-threatening leukoma. The visual acuity was increased in 10 out of 20 patients.

Discussion:

Fungal keratitis is characterized by treatment-resistant corneal ulcerations occurring especially after trauma with organic materials. Treatment success is achieved through early diagnosis and proper treatment. Clinical suspicion is essential. Microscopic evaluation of corneal scrapings can be helpful in guiding the diagnosis before culture results.

Keywords: Fungal keratitis, cytological evaluation, early diagnosis

Full Text (Turkish)