Diagnosis and medical treatment of fungal keratitis
A significant trend is a move away from yeast infections and toward filamentous fungal keratitis over the past decade
Matthew Burton PhD, London, UK, gave the keynote speech on infectious keratitis at the annual Cornea Day, during the 21st ESCRS Winter Meeting in Maastricht, The Netherlands.
“A significant trend is a move away from yeast infections and toward filamentous fungal keratitis over the past decade, which currently cause 70% of fungal infections in our hospital,” said Dr Burton. A reverse trend has been noted in candida infections.
Regarding the diagnostic approach, Dr Burton advised delegates to focus on potential risk factors, including contact lens use, ocular surface disease, trauma, surgery and especially tropical travel.
“Travel history is often overlooked, despite it’s great importance,” said Dr Burton. The closer the patient has travelled to the equator, the higher the proportion of fungal keratitis.
Diagnostics should include in vivo confocal microscopy (IVCM), scrape for microbiology, PCR and biopsy.
“IVCM can be a very valuable modality, particularly for deeper infections not amenable to the other diagnostic approaches,” he said.
IVCM can be a very valuable modality, particularly for deeper infections not amenable to the other diagnostic approaches
Dr Burton also reviewed the evidence that guided his approach to treatment. The most valuable studies compared topical treatments such as natamycin, voriconazole and chlorhexidine, as well as oral and intrastromal voriconazole. Dr Burton reminded delegates to be particularly careful with oral voriconazole, which can lead to fatal hepatotoxicity.
“Despite the potential for success of medical treatments, don’t be afraid to consider surgery with there’s no treatment response or when the limbus becomes involved,” he concluded.EUROTIMES Diagnosis and medical treatment of fungal keratitis LATEST
Joseph Colin Keratoconus AwardFriday, September 28, 2018
First recipients of the Joseph Colin Keratoconus Award.
Corneal biomechanical propertiesFriday, September 28, 2018
SIGNIFICANT advances are being made in unlocking the secrets of the cornea’s biomechanical properties
2018 Peter Barry FellowshipMonday, September 24, 2018
THE winner of this year’s Peter Barry Fellowship is Andreas Frings.
Practice Management ProgrammeMonday, September 24, 2018
Ophthalmologists and top marketing consultants advise ESCRS delegates on how they can best manage and grow their practices
ESCRS Poster Prize winnersMonday, September 24, 2018
Posters judged on originality, scientific quality, relevance to clinical practice and presentation.
2018 Video CompetitionMonday, September 24, 2018
THE winning videos in the 2018 Video Competition highlight some innovative independent research
The benefits of ‘facts first’Monday, September 24, 2018
Ophthalmology can benefit from more rigorous application of evidence-based medicine
Opening CeremonyMonday, September 24, 2018
The ESCRS will continue to innovate and fine-tune its mission
Femcat StudyMonday, September 24, 2018
Funded by the French Ministry of Health, FEMCAT is a large, randomised prospective study
Imaging aqueous outflowMonday, September 24, 2018
THE distal aqueous drainage tract is denser and much more complex than previously thought