June 05, 2013
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Peripheral infiltrates, hypopyon may influence response to fungal keratitis treatment

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Voriconazole successfully treated 50% of fungal keratitis cases, a study found.

The retrospective study included 26 patients with fungal keratitis who were treated with topical voriconazole. Fifteen patients also received oral voriconazole, seven patients underwent intracorneal injection, and two patients underwent intracameral injection.

The average interval between onset of symptoms and treatment was 11.8 days.

Investigators assessed clinical history, best corrected visual acuity and slit lamp biomicroscopy and obtained corneal scrapings for microbiological evaluation.

Thirteen patients (50%) responded to medical treatment. Penetrating keratoplasty was required in 11 patients (42.3%), and enucleation was required in two patients (7.7%) with severe non-responsive keratitis.

Factors associated with non-response to treatment were peripheral infiltrates and hypopyon, but the differences were not significant.

The most commonly identified fungal species were Fusarium (27%) and Candida (15.4%); Staphylococcus was the most common cause of microbial co-infection (30.8%), the authors said.