Fungal keratitis at a tertiary eye care in Northern Thailand: Etiology and prognostic factors for treatment outcomes

Purpose: To evaluate etiology and prognostic factors for treatment outcomes of fungal keratitis (FK). Methods: Culture-positive FK patients between 2012 and 2017 were reviewed. Treatment outcomes were categorized into success (resolved within two weeks), slow response and medication failure (no improvement or required surgery). Etiology and risk factors for poor treatment outcomes were analyzed. Results: A total of 113 eyes of 113 patients (77% males) were recruited. Ocular trauma (69.0%) was the most common predisposing factor. Of this, 80% were exposed to organic foreign bodies. The most common pathogen was Fusarium spp. (45.2%), while dematiaceous fungi were discovered in 29.6%. Medical treatment was successful in 24.8% of eyes, while 29.2% had a slow response and 42.5% failed medication. Therapeutic keratoplasty was performed in 22.1% of eyes and 11.5% eventually required eye removal. Significant risk factors for medication failure were advanced age (P = 0.005), delayed antifungal treatment (P = 0.038) and large-size lesion (P = 0.003). Conclusions: Ocular trauma was the major predisposing factor of FK in the Northern Thailand. Fusarium was the most common identified pathogen. Many cases were refractory to medications and required surgical intervention. Aging, delayed treatment and a large lesion were predictors for poor outcomes. (C) 2021 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Automated summary

The study evaluated the etiology and prognostic factors for fungal keratitis (FK) and found that ocular trauma was the major predisposing factor in Northern Thailand, with Fusarium being the most common identified pathogen. Many cases were refractory to medications and required surgical intervention, with advanced age, delayed treatment, and large lesion size being predictors for poor outcomes.