Clinical analysis of 176 cases of fungal keratitis in Jingzhou / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

AIM: To analyze the infection characteristics and clinical treatment outcome of patients with fungal keratitis(FK)in Jingzhou area, so as to provide basis for clinical diagnosis and treatment of FK. METHODS: The data of 176 patients with FK diagnosed by etiology in Jingzhou Central Hospital from January 2015 to July 2020 were collected, and the epidemiological characteristics, identification results of fungal strains, drug sensitivity and clinical treatment outcome of the patients were analyzed. RESULTS:Among the 176 patients with FK, 118 were male and 58 were female, and the ratio of male to female is 2.031. The age of onset was the largest number of patients in 50-59 years old and 60-69 years old. The peak seasons of onset were April to June and October to December. Risk factors include trauma and possible history of trauma, ocular surface diseases, post ophthalmic surgery, wearing corneal contact lenses and long-term local drug use. The main pathogens were Fusarium(39.8%), aspergillus(30.7%), alternaria(15.9%)and candida(5.1%). The results of drug sensitivity showed that voriconazole and amphotericin B were sensitive, while the drug resistance rate of fluconazole was very high. There were 125 eyes improved or cured after conservative treatment, 12 eyes were injected into corneal stroma, 15 eyes were covered with conjunctival flap or amniotic membrane transplantation, and 21 eyes were treated with corneal transplantation. Enucleation of ocular contents was performed in 8 eyes, including 5 eyes with severe endophthalmitis after conjunctival flap covering. CONCLUSION:The incidence of FK in Jingzhou area is mostly middle-aged and elderly men, mostly caused by corneal trauma in the process of agricultural labor. The main pathogens were fusarium and aspergillus. It is very important to select reasonable antifungal drugs and treatment methods according to the drug sensitivity results.