A total of 115 consecutive patients with fungal keratitis treated at one center during a 6-month period.
Methods
Patients with a microscopic corneal ulcer smear that was positive for fungus were enrolled and treated with 5% natamycin monotherapy according to the protocol of the hospital. Treatment responses were assessed at the end of 4 weeks. The prognostic indicators were used in a Poisson model for multiple regression analysis to estimate the relative risk of the main prognostic variables.
Main Outcome Measures
Response of the ulcer to treatment.
Results
Of the 115 patients analyzed in the study, 52 (45.2%) were treatment successes, 27 (23.5%) had slow-healing ulcers, and 36 (31.3%) were refractory to primary treatment. Multivariate analysis showed that the predictors of treatment failure were ulcers that exceeded 14 mm2 (P = 0.009), the presence of hypopyon (P = 0.003), and identification of Aspergillus (P = 0.003).
Conclusion
In patients with fungal keratitis treated with 5% natamycin monotherapy, larger ulcer size and infection with Aspergillus were predictors of a poor outcome.
1Department of Ocular Microbiology, Aravind Eye Hospital and PG Institute of Ophthalmology, Madurai, India.
2Department of Cornea and Refractive Surgery, Aravind Eye Hospital and PG Institute of Ophthalmology, Madurai, India.
3Department of Biostatistics, Aravind Eye Hospital and PG Institute of Ophthalmology, Madurai, India.
Correspondence to Prajna Lalitha, MD, Aravind Eye Hospital and PG Institute of Ophthalmology, 1, Anna Nagar, Madurai, Tamilnadu, India 625 020.
Manuscript no. 2005-209
No author has a financial interest or conflicting interest in any materials or methods mentioned in the article
ABSTRACT