Clinical Aspect and Prognosis of Alternaria Keratitis

PURPOSE: To investigate the risk factor, clinical manifestations, treatment results, and prognosis in Alternaria keratitis. METHODS: Thirteen eyes of 13 patients who were diagnosed as Alternaria species by corneal smear and culture were included. The past history, visual acuity, location and size of ulceration, hypopyon, treatment results, and prognosis were analyzed retrospectively. RESULTS: Nine (69.2%) were women, and 4 were men. The mean age was 65.23+/-8.70 years. Eleven eyes (84.6%) had previous history of corneal traumas by soil or plant material. In 7 eyes (53.8%), the lesions were located at the corneal center. The average size of ulceration was 13.90+/-21.80 mm2. Four eyes (30.8%) had hypopyon. The initial visual acuity was less than 0.1 in 10 eyes (76.9%). The final visual acuity improved more than 2 lines in 10 eyes (76.9%) and more than 1 line in 12 eyes (92.3%), and did not change in 1 eye (7.7%). The treatment success was achieved in 12 eyes (92.3%). CONCLUSIONS: Early diagnosis and specific antifungal treatments of Alternaria keratitis can lead to a good prognosis.

Epidemiologic study of Alternaria Keratitis

PURPOSE: Alternaria spp. is opportunistic fungus and the most prevalent cause of asthma and allergic disease. Keratitis caused by the fungus Alternariaspp. is quite rare. The authors performed an epidemiological study to identify the risk factor and to evaluate clinical manifestations, methods and results of treatment in Alternaria keratitis. METHODS: Epidemiological study of Alternaria keratitis was performed prospectively under the identical protocol from April 1995 to May 2000 in 5 hospitals. RESULTS: Seven cases of Alternaria keratitis were identified by culture with corneal scraping or corneal biopsy. They were 8.5% of the 82 cases of fungal keratitis. Of the 7 patients, 5 were men (71.4%). All patients were over 50 years and 5 of them (71.4%) were farmers. In terms of trauma history, 6 out of 7 patients had previous history of corneal traumas, and most of these corneal traumas were vegetable matter-related. CONCLUSIONS: The most common (83.3%) predisposing factor for Alternaria keratitis was vegetable matter-related corneal trauma. The prompt referral for diagnostic studies and specific antifungal management, or surgical therapy might be helpful to reduce the incidence rate of complication of keratomycoses.