Epidemiologic aspects and clinical outcome of fungal keratitis in southeastern Brazil.
OBJECTIVE
Fungal keratitis (FK) is a sight-threatening disease, more prevalent in developing regions. The present retrospective study was conducted in order to evaluate the epidemiologic and clinical aspects and the progression of FK in patients treated at two ophthalmologic reference centers in Southeast Brazil.


METHODS
The charts of patients with infectious keratitis treated between 2000 and 2004 were reviewed. For the 66 cases of FK confirmed by microbiological analysis, data related to patient, disease, and therapeutic approaches were obtained.


RESULTS
Mean patient age was 40.7+/-16 years. Fifty-three were men and 13 were women. Ocular trauma occurred in 40% of cases (27). Previous medications taken by the patients were quinolone in 72.5% and antimycotics in 30%. Visual acuity (VA) at presentation was >0.3 in 16% and <0.1 in 74.5%. Penetrant keratoplasty was performed in 38% and evisceration in 15%. The causing agents were Fusarium sp in 67%, Aspergillus sp in 10.5%, and Candida sp in 10%. Medication alone resolved 39% of cases within a mean period of 24.5+/-12 days. Final VA was >0.3 in 28%, and <0.1 in 63%.


CONCLUSIONS
Fungal keratitis presented as a disease with severe complications, predominantly among young males, and was mostly caused by filamentous fungi. The present information permits the establishment of preventive strategies. Reducing the time between onset and treatment and using more accessible specific medication would reverse the negative prognosis.
Ibrahim
Marlon Moraes
MM
Department of Ophthalmology, Faculty of Medicine of Ribeirão Preto, São Paulo University, São Paulo - Brazil.
Vanini
Rafael
R
Ibrahim
Fuad Moraes
FM
Fioriti
Livia S
LS
Furlan
Eloisa M R
EM
Provinzano
Luciana M A
LM
De Castro
Rosane S
RS
Sousa
Sidney Julio De Faria E
SJ
Rocha
Eduardo Melani
EM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001230:Aspergillus / Q000302:isolation & purification; D001938:Brazil / Q000453:epidemiology; D002175:Candida / Q000302:isolation & purification; D002648:Child; D003320:Corneal Ulcer / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy; D018450:Disease Progression; D016021:Epidemiologic Studies; D015821:Eye Infections, Fungal / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005670:Fusarium / Q000302:isolation & purification; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
D000935:Antifungal Agents