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Published in: Current Fungal Infection Reports 3/2013

01-09-2013 | Clinical Lab Issues (M Brandt, Section Editor)

Current Thoughts in Fungal Keratitis: Diagnosis and Treatment

Authors: Zubair Ansari, Darlene Miller, Anat Galor

Published in: Current Fungal Infection Reports | Issue 3/2013

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Abstract

Fungal keratitis remains a challenging and often elusive diagnosis in geographic regions where it is endemic. Marred by delays in diagnosis, the sequelae of corneal fungal infections, though preventable, can be irreversible. Recent studies and advances in the arena have broadened the approach and treatment to mycotic keratitis. This review will discuss current diagnostic modalities of fungal keratitis and will particularly focus on treatment regimens. It will also explore future therapeutic models and critique the potential benefit of each.
Literature
1.
go back to reference Wong TY, Ng TP, Fong KS, Tan DT. Risk factors and clinical outcomes between fungal and bacterial keratitis: a comparative study. CLAO J. 1997;23:275–81.PubMed Wong TY, Ng TP, Fong KS, Tan DT. Risk factors and clinical outcomes between fungal and bacterial keratitis: a comparative study. CLAO J. 1997;23:275–81.PubMed
2.
go back to reference • Sharma N, Chacko J, Velpandian T, et al. Comparative Evaluation of Topical versus Intrastromal Voriconazole as an Adjunct to Natamycin in Recalcitrant Fungal Keratitis. Ophthalmology 2012. Important trial that compared topical and intrastromal voriconazole in adjunct to natamycin. Showed no significant difference between topical and intrastromal voriconazole in best corrected visual acuity. • Sharma N, Chacko J, Velpandian T, et al. Comparative Evaluation of Topical versus Intrastromal Voriconazole as an Adjunct to Natamycin in Recalcitrant Fungal Keratitis. Ophthalmology 2012. Important trial that compared topical and intrastromal voriconazole in adjunct to natamycin. Showed no significant difference between topical and intrastromal voriconazole in best corrected visual acuity.
3.
go back to reference Bharathi MJ, Ramakrishnan R, Meenakshi R, Padmavathy S, Shivakumar C, Srinivasan M. Microbial keratitis in South India: influence of risk factors, climate, and geographical variation. Ophthalmic Epidemiol. 2007;14:61–9.PubMedCrossRef Bharathi MJ, Ramakrishnan R, Meenakshi R, Padmavathy S, Shivakumar C, Srinivasan M. Microbial keratitis in South India: influence of risk factors, climate, and geographical variation. Ophthalmic Epidemiol. 2007;14:61–9.PubMedCrossRef
4.
go back to reference Leck AK, Thomas PA, Hagan M, et al. Aetiology of suppurative corneal ulcers in Ghana and south India, and epidemiology of fungal keratitis. Br J Ophthalmol. 2002;86:1211–5.PubMedCrossRef Leck AK, Thomas PA, Hagan M, et al. Aetiology of suppurative corneal ulcers in Ghana and south India, and epidemiology of fungal keratitis. Br J Ophthalmol. 2002;86:1211–5.PubMedCrossRef
5.
6.
7.
go back to reference Tarabishy AB, Aldabagh B, Sun Y, et al. MyD88 regulation of Fusarium keratitis is dependent on TLR4 and IL-1R1 but not TLR2. J Immunol. 2008;181:593–600.PubMed Tarabishy AB, Aldabagh B, Sun Y, et al. MyD88 regulation of Fusarium keratitis is dependent on TLR4 and IL-1R1 but not TLR2. J Immunol. 2008;181:593–600.PubMed
8.
go back to reference Thomas PA, Kaliamurthy J. Mycotic keratitis: epidemiology, diagnosis and management. Clin Microbiol Infect. 2013;19:210–20.PubMedCrossRef Thomas PA, Kaliamurthy J. Mycotic keratitis: epidemiology, diagnosis and management. Clin Microbiol Infect. 2013;19:210–20.PubMedCrossRef
9.
go back to reference Sun RL, Jones DB, Wilhelmus KR. Clinical characteristics and outcome of Candida keratitis. Am J Ophthalmol. 2007;143:1043–5.PubMedCrossRef Sun RL, Jones DB, Wilhelmus KR. Clinical characteristics and outcome of Candida keratitis. Am J Ophthalmol. 2007;143:1043–5.PubMedCrossRef
10.
go back to reference Gower EW, Keay LJ, Oechsler RA, et al. Trends in fungal keratitis in the United States, 2001 to 2007. Ophthalmology. 2010;117:2263–7.PubMedCrossRef Gower EW, Keay LJ, Oechsler RA, et al. Trends in fungal keratitis in the United States, 2001 to 2007. Ophthalmology. 2010;117:2263–7.PubMedCrossRef
11.
go back to reference •• Gopinathan U, Garg P, Fernandes M, Sharma S, Athmanathan S, Rao GN. The epidemiological features and laboratory results of fungal keratitis: a 10-year review at a referral eye care center in South India. Cornea. 2002;21:555–9. This review presented the epidemiological features and laboratory results of the largest series of fungal keratitis ever reported in literature. Identified demographic features and risk factors that contributed to our knowledge of how FK is aquired.PubMedCrossRef •• Gopinathan U, Garg P, Fernandes M, Sharma S, Athmanathan S, Rao GN. The epidemiological features and laboratory results of fungal keratitis: a 10-year review at a referral eye care center in South India. Cornea. 2002;21:555–9. This review presented the epidemiological features and laboratory results of the largest series of fungal keratitis ever reported in literature. Identified demographic features and risk factors that contributed to our knowledge of how FK is aquired.PubMedCrossRef
12.
go back to reference Sirikul T, Prabriputaloong T, Smathivat A, Chuck RS, Vongthongsri A. Predisposing factors and etiologic diagnosis of ulcerative keratitis. Cornea. 2008;27:283–7.PubMedCrossRef Sirikul T, Prabriputaloong T, Smathivat A, Chuck RS, Vongthongsri A. Predisposing factors and etiologic diagnosis of ulcerative keratitis. Cornea. 2008;27:283–7.PubMedCrossRef
13.
go back to reference Srinivasan M, Gonzales CA, George C, et al. Epidemiology and aetiological diagnosis of corneal ulceration in Madurai, south India. Br J Ophthalmol. 1997;81:965–71.PubMedCrossRef Srinivasan M, Gonzales CA, George C, et al. Epidemiology and aetiological diagnosis of corneal ulceration in Madurai, south India. Br J Ophthalmol. 1997;81:965–71.PubMedCrossRef
14.
go back to reference Foster CS. Fungal keratitis. Infect Dis Clin North Am. 1992;6:851–7.PubMed Foster CS. Fungal keratitis. Infect Dis Clin North Am. 1992;6:851–7.PubMed
15.
go back to reference Pepose JS, Wilhelmus KR. Divergent approaches to the management of corneal ulcers. Am J Ophthalmol. 1992;114:630–2.PubMed Pepose JS, Wilhelmus KR. Divergent approaches to the management of corneal ulcers. Am J Ophthalmol. 1992;114:630–2.PubMed
16.
go back to reference Chin GN, Hyndiuk RA, Kwasny GP, Schultz RO. Keratomycosis in Wisconsin. Am J Ophthalmol. 1975;79:121–5.PubMed Chin GN, Hyndiuk RA, Kwasny GP, Schultz RO. Keratomycosis in Wisconsin. Am J Ophthalmol. 1975;79:121–5.PubMed
17.
go back to reference Doughman DJ, Leavenworth NM, Campbell RC, Lindstrom RL. Fungal keratitis at the University of Minnesota: 1971–1981. Trans Am Ophthalmol Soc. 1982;80:235–47.PubMed Doughman DJ, Leavenworth NM, Campbell RC, Lindstrom RL. Fungal keratitis at the University of Minnesota: 1971–1981. Trans Am Ophthalmol Soc. 1982;80:235–47.PubMed
18.
go back to reference Jones DB, Sexton R, Rebell G. Mycotic keratitis in South Florida: a review of thirty-nine cases. Trans Ophthalmol Soc U K. 1970;89:781–97.PubMed Jones DB, Sexton R, Rebell G. Mycotic keratitis in South Florida: a review of thirty-nine cases. Trans Ophthalmol Soc U K. 1970;89:781–97.PubMed
19.
go back to reference Rosa Jr RH, Miller D, Alfonso EC. The changing spectrum of fungal keratitis in south Florida. Ophthalmology. 1994;101:1005–13.PubMed Rosa Jr RH, Miller D, Alfonso EC. The changing spectrum of fungal keratitis in south Florida. Ophthalmology. 1994;101:1005–13.PubMed
20.
go back to reference Bullock JD, Elder BL, Khamis HJ, Warwar RE. Effects of time, temperature, and storage container on the growth of Fusarium species: implications for the worldwide Fusarium keratitis epidemic of 2004–2006. Arch Ophthalmol. 2011;129:133–6.PubMedCrossRef Bullock JD, Elder BL, Khamis HJ, Warwar RE. Effects of time, temperature, and storage container on the growth of Fusarium species: implications for the worldwide Fusarium keratitis epidemic of 2004–2006. Arch Ophthalmol. 2011;129:133–6.PubMedCrossRef
21.
go back to reference Jones BR. Principles in the management of oculomycosis. XXXI Edward Jackson memorial lecture. Am J Ophthalmol. 1975;79:719–51.PubMed Jones BR. Principles in the management of oculomycosis. XXXI Edward Jackson memorial lecture. Am J Ophthalmol. 1975;79:719–51.PubMed
22.
go back to reference Dahlgren MA, Lingappan A, Wilhelmus KR. The clinical diagnosis of microbial keratitis. Am J Ophthalmol. 2007;143:940–4.PubMedCrossRef Dahlgren MA, Lingappan A, Wilhelmus KR. The clinical diagnosis of microbial keratitis. Am J Ophthalmol. 2007;143:940–4.PubMedCrossRef
23.
go back to reference •• Prajna NV, Mascarenhas J, Krishnan T, et al. Comparison of natamycin and voriconazole for the treatment of fungal keratitis. Arch Ophthalmol. 2010;128:672–8. Important study that compared the use of natamycin and voriconazole in fungal keratitis, and to establish voriconazole as a worthy agent in FK.PubMedCrossRef •• Prajna NV, Mascarenhas J, Krishnan T, et al. Comparison of natamycin and voriconazole for the treatment of fungal keratitis. Arch Ophthalmol. 2010;128:672–8. Important study that compared the use of natamycin and voriconazole in fungal keratitis, and to establish voriconazole as a worthy agent in FK.PubMedCrossRef
24.
go back to reference McLeod SD, Kolahdouz-Isfahani A, Rostamian K, Flowers CW, Lee PP, McDonnell PJ. The role of smears, cultures, and antibiotic sensitivity testing in the management of suspected infectious keratitis. Ophthalmology. 1996;103:23–8.PubMed McLeod SD, Kolahdouz-Isfahani A, Rostamian K, Flowers CW, Lee PP, McDonnell PJ. The role of smears, cultures, and antibiotic sensitivity testing in the management of suspected infectious keratitis. Ophthalmology. 1996;103:23–8.PubMed
25.
go back to reference Zhang W, Yang H, Jiang L, Han L, Wang L. Use of potassium hydroxide, Giemsa and calcofluor white staining techniques in the microscopic evaluation of corneal scrapings for diagnosis of fungal keratitis. J Int Med Res. 2010;38:1961–7.PubMedCrossRef Zhang W, Yang H, Jiang L, Han L, Wang L. Use of potassium hydroxide, Giemsa and calcofluor white staining techniques in the microscopic evaluation of corneal scrapings for diagnosis of fungal keratitis. J Int Med Res. 2010;38:1961–7.PubMedCrossRef
26.
go back to reference •• Sharma S, Kunimoto DY, Gopinathan U, Athmanathan S, Garg P, Rao GN. Evaluation of corneal scraping smear examination methods in the diagnosis of bacterial and fungal keratitis: a survey of eight years of laboratory experience. Cornea. 2002;21:643–7. Determined the sensitivity, specificity, and predictive values of Gram and potassium hydroxide with calcofluor white stains in the diagnosis of early and advanced microbial keratitis. Found that KOH prep with calcofluor white is a reliable lab test in the diagnosis of mycotic keratitis.PubMedCrossRef •• Sharma S, Kunimoto DY, Gopinathan U, Athmanathan S, Garg P, Rao GN. Evaluation of corneal scraping smear examination methods in the diagnosis of bacterial and fungal keratitis: a survey of eight years of laboratory experience. Cornea. 2002;21:643–7. Determined the sensitivity, specificity, and predictive values of Gram and potassium hydroxide with calcofluor white stains in the diagnosis of early and advanced microbial keratitis. Found that KOH prep with calcofluor white is a reliable lab test in the diagnosis of mycotic keratitis.PubMedCrossRef
27.
go back to reference McGinnis M. Laboratory handbook of medical mycology. New York: Academic Press; 1980. McGinnis M. Laboratory handbook of medical mycology. New York: Academic Press; 1980.
28.
go back to reference Dursun D, Fernandez V, Miller D, Alfonso EC. Advanced Fusarium keratitis progressing to endophthalmitis. Cornea. 2003;22:300–3.PubMedCrossRef Dursun D, Fernandez V, Miller D, Alfonso EC. Advanced Fusarium keratitis progressing to endophthalmitis. Cornea. 2003;22:300–3.PubMedCrossRef
29.
go back to reference Keay LJ, Gower EW, Iovieno A, et al. Clinical and microbiological characteristics of fungal keratitis in the United States, 2001–2007: a multicenter study. Ophthalmology 2011. Keay LJ, Gower EW, Iovieno A, et al. Clinical and microbiological characteristics of fungal keratitis in the United States, 2001–2007: a multicenter study. Ophthalmology 2011.
30.
go back to reference Ferrer C, Alio JL. Evaluation of molecular diagnosis in fungal keratitis. Ten years of experience. Journal of Ophthalmic Inflammation and Infection. 2011;1:15–22.PubMedCrossRef Ferrer C, Alio JL. Evaluation of molecular diagnosis in fungal keratitis. Ten years of experience. Journal of Ophthalmic Inflammation and Infection. 2011;1:15–22.PubMedCrossRef
31.
go back to reference Erie JC, McLaren JW, Patel SV. Confocal microscopy in ophthalmology. Am J Ophthalmol. 2009;148:639–46.PubMedCrossRef Erie JC, McLaren JW, Patel SV. Confocal microscopy in ophthalmology. Am J Ophthalmol. 2009;148:639–46.PubMedCrossRef
32.
go back to reference • Vaddavalli PK, Garg P, Sharma S, Sangwan VS, Rao GN, Thomas R. Role of confocal microscopy in the diagnosis of fungal and acanthamoeba keratitis. Ophthalmology. 2011;118:29–35. Prospective, double masked study that evaluated the sensitivity, specificity, NPV and PPV of confocal microscopy. Proposed it as an accurate and reliable diagnostic modality in the diagnosis of fungal and Acanthamoeba keratitis.PubMedCrossRef • Vaddavalli PK, Garg P, Sharma S, Sangwan VS, Rao GN, Thomas R. Role of confocal microscopy in the diagnosis of fungal and acanthamoeba keratitis. Ophthalmology. 2011;118:29–35. Prospective, double masked study that evaluated the sensitivity, specificity, NPV and PPV of confocal microscopy. Proposed it as an accurate and reliable diagnostic modality in the diagnosis of fungal and Acanthamoeba keratitis.PubMedCrossRef
33.
go back to reference Florcruz NV, Peczon I, Jr. Medical interventions for fungal keratitis. Cochrane database of systematic reviews 2008:CD004241. Florcruz NV, Peczon I, Jr. Medical interventions for fungal keratitis. Cochrane database of systematic reviews 2008:CD004241.
34.
go back to reference Yoon KC, Jeong IY, Im SK, Chae HJ, Yang SY. Therapeutic effect of intracameral amphotericin B injection in the treatment of fungal keratitis. Cornea. 2007;26:814–8.PubMedCrossRef Yoon KC, Jeong IY, Im SK, Chae HJ, Yang SY. Therapeutic effect of intracameral amphotericin B injection in the treatment of fungal keratitis. Cornea. 2007;26:814–8.PubMedCrossRef
36.
go back to reference Green WR, Bennett JE, Goos RD. Ocular penetration of amphotericin B: a report of laboratory studies and a case report of postsurgical cephalosporium endophthalmitis. Arch Ophthalmol. 1965;73:769–75.PubMedCrossRef Green WR, Bennett JE, Goos RD. Ocular penetration of amphotericin B: a report of laboratory studies and a case report of postsurgical cephalosporium endophthalmitis. Arch Ophthalmol. 1965;73:769–75.PubMedCrossRef
37.
go back to reference Natamycin approved--first U.S. drug for fungal keratitis. FDA Drug Bull 1978;8:37–8. Natamycin approved--first U.S. drug for fungal keratitis. FDA Drug Bull 1978;8:37–8.
38.
go back to reference Medoff G, Kobayashi GS. Strategies in the treatment of systemic fungal infections. N Engl J Med. 1980;302:145–55.PubMedCrossRef Medoff G, Kobayashi GS. Strategies in the treatment of systemic fungal infections. N Engl J Med. 1980;302:145–55.PubMedCrossRef
39.
go back to reference Kalavathy CM, Parmar P, Kaliamurthy J, et al. Comparison of topical itraconazole 1 % with topical natamycin 5 % for the treatment of filamentous fungal keratitis. Cornea. 2005;24:449–52.PubMedCrossRef Kalavathy CM, Parmar P, Kaliamurthy J, et al. Comparison of topical itraconazole 1 % with topical natamycin 5 % for the treatment of filamentous fungal keratitis. Cornea. 2005;24:449–52.PubMedCrossRef
40.
go back to reference Tanure MA, Cohen EJ, Sudesh S, Rapuano CJ, Laibson PR. Spectrum of fungal keratitis at Wills Eye Hospital, Philadelphia, Pennsylvania. Cornea. 2000;19:307–12.PubMedCrossRef Tanure MA, Cohen EJ, Sudesh S, Rapuano CJ, Laibson PR. Spectrum of fungal keratitis at Wills Eye Hospital, Philadelphia, Pennsylvania. Cornea. 2000;19:307–12.PubMedCrossRef
41.
go back to reference •• Marangon FB, Miller D, Giaconi JA, Alfonso EC. In vitro investigation of voriconazole susceptibility for keratitis and endophthalmitis fungal pathogens. Am J Ophthalmol. 2004;137:820–5. Experimental study that used a large microbiology database to investigate the susceptbility profile of the most common fungal pathogens in keratitis. First proposed the role of voriconazole in the therapeutic management of Candida and Aspergillus ocular infections.PubMedCrossRef •• Marangon FB, Miller D, Giaconi JA, Alfonso EC. In vitro investigation of voriconazole susceptibility for keratitis and endophthalmitis fungal pathogens. Am J Ophthalmol. 2004;137:820–5. Experimental study that used a large microbiology database to investigate the susceptbility profile of the most common fungal pathogens in keratitis. First proposed the role of voriconazole in the therapeutic management of Candida and Aspergillus ocular infections.PubMedCrossRef
42.
go back to reference Lalitha P, Shapiro BL, Srinivasan M, et al. Antimicrobial susceptibility of Fusarium, Aspergillus, and other filamentous fungi isolated from keratitis. Arch Ophthalmol. 2007;125:789–93.PubMedCrossRef Lalitha P, Shapiro BL, Srinivasan M, et al. Antimicrobial susceptibility of Fusarium, Aspergillus, and other filamentous fungi isolated from keratitis. Arch Ophthalmol. 2007;125:789–93.PubMedCrossRef
43.
go back to reference Hariprasad SM, Mieler WF, Lin TK, Sponsel WE, Graybill JR. Voriconazole in the treatment of fungal eye infections: a review of current literature. Br J Ophthalmol. 2008;92:871–8.PubMedCrossRef Hariprasad SM, Mieler WF, Lin TK, Sponsel WE, Graybill JR. Voriconazole in the treatment of fungal eye infections: a review of current literature. Br J Ophthalmol. 2008;92:871–8.PubMedCrossRef
44.
go back to reference Ramakrishnan T, Constantinou M, Jhanji V, Vajpayee RB. Factors affecting treatment outcomes with voriconazole in cases with fungal keratitis. Cornea. 2013;32:445–9.PubMedCrossRef Ramakrishnan T, Constantinou M, Jhanji V, Vajpayee RB. Factors affecting treatment outcomes with voriconazole in cases with fungal keratitis. Cornea. 2013;32:445–9.PubMedCrossRef
45.
go back to reference Prajna NV, Nirmalan PK, Mahalakshmi R, Lalitha P, Srinivasan M. Concurrent use of 5 % natamycin and 2 % econazole for the management of fungal keratitis. Cornea. 2004;23:793–6.PubMedCrossRef Prajna NV, Nirmalan PK, Mahalakshmi R, Lalitha P, Srinivasan M. Concurrent use of 5 % natamycin and 2 % econazole for the management of fungal keratitis. Cornea. 2004;23:793–6.PubMedCrossRef
46.
go back to reference Panda A, Sharma N, Angra SK. Topical fluconazole therapy of Candida keratitis. Cornea. 1996;15:373–5.PubMedCrossRef Panda A, Sharma N, Angra SK. Topical fluconazole therapy of Candida keratitis. Cornea. 1996;15:373–5.PubMedCrossRef
47.
go back to reference Rao SK, Madhavan HN, Rao G, Padmanabhan P. Fluconazole in filamentous fungal keratitis. Cornea. 1997;16:700.PubMedCrossRef Rao SK, Madhavan HN, Rao G, Padmanabhan P. Fluconazole in filamentous fungal keratitis. Cornea. 1997;16:700.PubMedCrossRef
48.
go back to reference Mahdy RA, Nada WM, Wageh MM. Topical amphotericin B and subconjunctival injection of fluconazole (combination therapy) versus topical amphotericin B (monotherapy) in treatment of keratomycosis. J Ocul Pharmacol Ther. 2010;26:281–5.PubMedCrossRef Mahdy RA, Nada WM, Wageh MM. Topical amphotericin B and subconjunctival injection of fluconazole (combination therapy) versus topical amphotericin B (monotherapy) in treatment of keratomycosis. J Ocul Pharmacol Ther. 2010;26:281–5.PubMedCrossRef
49.
go back to reference Sonego-Krone S, Sanchez-Di Martino D, Ayala-Lugo R, et al. Clinical results of topical fluconazole for the treatment of filamentous fungal keratitis. Graefes Arch Clin Exp Ophthalmol. 2006;244:782–7.PubMedCrossRef Sonego-Krone S, Sanchez-Di Martino D, Ayala-Lugo R, et al. Clinical results of topical fluconazole for the treatment of filamentous fungal keratitis. Graefes Arch Clin Exp Ophthalmol. 2006;244:782–7.PubMedCrossRef
50.
go back to reference Fitzsimons R, Peters AL. Miconazole and ketoconazole as a satisfactory first-line treatment for keratomycosis. Am J Ophthalmol. 1986;101:605–8.PubMed Fitzsimons R, Peters AL. Miconazole and ketoconazole as a satisfactory first-line treatment for keratomycosis. Am J Ophthalmol. 1986;101:605–8.PubMed
51.
go back to reference Perez-Balbuena AL, Vanzzini-Rosano V, Valadez-Virgen Jde J, Campos-Moller X. Fusarium keratitis in Mexico. Cornea. 2009;28:626–30.PubMedCrossRef Perez-Balbuena AL, Vanzzini-Rosano V, Valadez-Virgen Jde J, Campos-Moller X. Fusarium keratitis in Mexico. Cornea. 2009;28:626–30.PubMedCrossRef
52.
go back to reference Anane S, Ben Ayed N, Malek I, et al. Keratomycosis in the area of Tunis: epidemiological data, diagnostic and therapeutic modalities. Ann Biol Clin (Paris). 2010;68:441–7. Anane S, Ben Ayed N, Malek I, et al. Keratomycosis in the area of Tunis: epidemiological data, diagnostic and therapeutic modalities. Ann Biol Clin (Paris). 2010;68:441–7.
53.
go back to reference Mahdy RA, Nada WM, Wageh MM, Kader MA, Saleh MM, Alswad MM. Assessment safety and efficacy of a combination therapy of topical amphotericin B and subconjunctival fluconazole for the treatment of fungal keratitis. Cutan Ocul Toxicol. 2010;29:193–7.PubMedCrossRef Mahdy RA, Nada WM, Wageh MM, Kader MA, Saleh MM, Alswad MM. Assessment safety and efficacy of a combination therapy of topical amphotericin B and subconjunctival fluconazole for the treatment of fungal keratitis. Cutan Ocul Toxicol. 2010;29:193–7.PubMedCrossRef
54.
go back to reference Li L, Wang Z, Li R, Luo S, Sun X. In vitro evaluation of combination antifungal activity against Fusarium species isolated from ocular tissues of keratomycosis patients. Am J Ophthalmol. 2008;146:724–8.PubMedCrossRef Li L, Wang Z, Li R, Luo S, Sun X. In vitro evaluation of combination antifungal activity against Fusarium species isolated from ocular tissues of keratomycosis patients. Am J Ophthalmol. 2008;146:724–8.PubMedCrossRef
55.
go back to reference Xie L, Dong X, Shi W. Treatment of fungal keratitis by penetrating keratoplasty. Br J Ophthalmol. 2001;85:1070–4.PubMedCrossRef Xie L, Dong X, Shi W. Treatment of fungal keratitis by penetrating keratoplasty. Br J Ophthalmol. 2001;85:1070–4.PubMedCrossRef
56.
go back to reference Sharma N, Agarwal P, Sinha R, Titiyal JS, Velpandian T, Vajpayee RB. Evaluation of intrastromal voriconazole injection in recalcitrant deep fungal keratitis: case series. Br J Ophthalmol 2011. Sharma N, Agarwal P, Sinha R, Titiyal JS, Velpandian T, Vajpayee RB. Evaluation of intrastromal voriconazole injection in recalcitrant deep fungal keratitis: case series. Br J Ophthalmol 2011.
57.
go back to reference Siatiri H, Daneshgar F, Siatiri N. Khodabande A. Cornea: The effects of intrastromal voriconazole injection and topical voriconazole in the treatment of recalcitrant Fusarium keratitis; 2011. Siatiri H, Daneshgar F, Siatiri N. Khodabande A. Cornea: The effects of intrastromal voriconazole injection and topical voriconazole in the treatment of recalcitrant Fusarium keratitis; 2011.
58.
go back to reference Prakash G, Sharma N, Goel M, Titiyal JS, Vajpayee RB. Evaluation of intrastromal injection of voriconazole as a therapeutic adjunctive for the management of deep recalcitrant fungal keratitis. Am J Ophthalmol. 2008;146:56–9.PubMedCrossRef Prakash G, Sharma N, Goel M, Titiyal JS, Vajpayee RB. Evaluation of intrastromal injection of voriconazole as a therapeutic adjunctive for the management of deep recalcitrant fungal keratitis. Am J Ophthalmol. 2008;146:56–9.PubMedCrossRef
59.
go back to reference Wei LC, Tsai TC, Tsai HY, Wang CY, Shen YC. Comparison of voriconazole concentration in the aqueous humor and vitreous between non-scraped and scraped corneal epithelium groups after topical 1 % voriconazole application. Curr Eye Res. 2010;35:573–9.PubMedCrossRef Wei LC, Tsai TC, Tsai HY, Wang CY, Shen YC. Comparison of voriconazole concentration in the aqueous humor and vitreous between non-scraped and scraped corneal epithelium groups after topical 1 % voriconazole application. Curr Eye Res. 2010;35:573–9.PubMedCrossRef
60.
go back to reference •• Xie L, Zhai H, Shi W. Penetrating keratoplasty for corneal perforations in fungal keratitis. Cornea. 2007;26:158–62. Retrospective study that determined penetrating keratoplasty (PKP) an effective surgical treatment of antifungal refractory mycotic keratitis.PubMedCrossRef •• Xie L, Zhai H, Shi W. Penetrating keratoplasty for corneal perforations in fungal keratitis. Cornea. 2007;26:158–62. Retrospective study that determined penetrating keratoplasty (PKP) an effective surgical treatment of antifungal refractory mycotic keratitis.PubMedCrossRef
61.
go back to reference Garg P, Gopinathan U, Nutheti R, Rao GN. Clinical experience with N-butyl cyanoacrylate tissue adhesive in fungal keratitis. Cornea. 2003;22:405–8.PubMedCrossRef Garg P, Gopinathan U, Nutheti R, Rao GN. Clinical experience with N-butyl cyanoacrylate tissue adhesive in fungal keratitis. Cornea. 2003;22:405–8.PubMedCrossRef
62.
go back to reference Tseng SC. Amniotic membrane transplantation for ocular surface reconstruction. Biosci Rep. 2001;21:481–9.PubMedCrossRef Tseng SC. Amniotic membrane transplantation for ocular surface reconstruction. Biosci Rep. 2001;21:481–9.PubMedCrossRef
63.
go back to reference Chen HC, Tan HY, Hsiao CH, Huang SC, Lin KK, Ma DH. Amniotic membrane transplantation for persistent corneal ulcers and perforations in acute fungal keratitis. Cornea. 2006;25:564–72.PubMedCrossRef Chen HC, Tan HY, Hsiao CH, Huang SC, Lin KK, Ma DH. Amniotic membrane transplantation for persistent corneal ulcers and perforations in acute fungal keratitis. Cornea. 2006;25:564–72.PubMedCrossRef
64.
go back to reference Bell NP, Karp CL, Alfonso EC, Schiffman J, Miller D. Effects of methylprednisolone and cyclosporine A on fungal growth in vitro. Cornea. 1999;18:306–13.PubMedCrossRef Bell NP, Karp CL, Alfonso EC, Schiffman J, Miller D. Effects of methylprednisolone and cyclosporine A on fungal growth in vitro. Cornea. 1999;18:306–13.PubMedCrossRef
65.
go back to reference Price Jr FW, Price MO. Descemet's stripping with endothelial keratoplasty in 50 eyes: a refractive neutral corneal transplant. J Refract Surg. 2005;21:339–45.PubMed Price Jr FW, Price MO. Descemet's stripping with endothelial keratoplasty in 50 eyes: a refractive neutral corneal transplant. J Refract Surg. 2005;21:339–45.PubMed
66.
go back to reference Reddy JC, Hammersmith KM, Nagra PK, Rapuano CJ. The role of penetrating keratoplasty in the era of selective lamellar keratoplasty. Int Ophthalmol Clin. 2013;53:91–101.PubMedCrossRef Reddy JC, Hammersmith KM, Nagra PK, Rapuano CJ. The role of penetrating keratoplasty in the era of selective lamellar keratoplasty. Int Ophthalmol Clin. 2013;53:91–101.PubMedCrossRef
67.
go back to reference Qu LJ, Xie LX. Changing indications for lamellar keratoplasty in Shandong, 1993–2008. Chin Med J (Engl). 2010;123:3268–71. Qu LJ, Xie LX. Changing indications for lamellar keratoplasty in Shandong, 1993–2008. Chin Med J (Engl). 2010;123:3268–71.
68.
go back to reference •• Xie L, Shi W, Liu Z, Li S. Lamellar keratoplasty for the treatment of fungal keratitis. Cornea. 2002;21:33–7. These studies evaluated lamellar keratoplasty as an effective surgical intervention in the setting of antifungal refractory FK.PubMedCrossRef •• Xie L, Shi W, Liu Z, Li S. Lamellar keratoplasty for the treatment of fungal keratitis. Cornea. 2002;21:33–7. These studies evaluated lamellar keratoplasty as an effective surgical intervention in the setting of antifungal refractory FK.PubMedCrossRef
69.
go back to reference Xie L, Zhong W, Shi W, Sun S. Spectrum of fungal keratitis in north China. Ophthalmology. 2006;113:1943–8.PubMedCrossRef Xie L, Zhong W, Shi W, Sun S. Spectrum of fungal keratitis in north China. Ophthalmology. 2006;113:1943–8.PubMedCrossRef
70.
go back to reference Hu JZ, Xie LX. Clinical study on the recurrence of fungal keratitis after lamellar keratoplasty. [Zhonghua yan ke za zhi]. Chinese Journal of Ophthalmology. 2008;44:111–5.PubMed Hu JZ, Xie LX. Clinical study on the recurrence of fungal keratitis after lamellar keratoplasty. [Zhonghua yan ke za zhi]. Chinese Journal of Ophthalmology. 2008;44:111–5.PubMed
71.
go back to reference Anshu A, Parthasarathy A, Mehta JS, Htoon HM, Tan DT. Outcomes of therapeutic deep lamellar keratoplasty and penetrating keratoplasty for advanced infectious keratitis: a comparative study. Ophthalmology. 2009;116:615–23.PubMedCrossRef Anshu A, Parthasarathy A, Mehta JS, Htoon HM, Tan DT. Outcomes of therapeutic deep lamellar keratoplasty and penetrating keratoplasty for advanced infectious keratitis: a comparative study. Ophthalmology. 2009;116:615–23.PubMedCrossRef
72.
go back to reference Xie L, Zhai H, Zhao J, Sun S, Shi W, Dong X. Antifungal susceptibility for common pathogens of fungal keratitis in Shandong Province, China. Am J Ophthalmol. 2008;146:260–5.PubMedCrossRef Xie L, Zhai H, Zhao J, Sun S, Shi W, Dong X. Antifungal susceptibility for common pathogens of fungal keratitis in Shandong Province, China. Am J Ophthalmol. 2008;146:260–5.PubMedCrossRef
73.
go back to reference Khairallah SH, Byrne KA, Tabbara KF. Fungal keratitis in Saudi Arabia. Doc Ophthalmol. 1992;79:269–76.PubMedCrossRef Khairallah SH, Byrne KA, Tabbara KF. Fungal keratitis in Saudi Arabia. Doc Ophthalmol. 1992;79:269–76.PubMedCrossRef
74.
go back to reference Bhartiya P, Daniell M, Constantinou M, Islam FM, Taylor HR. Fungal keratitis in Melbourne. Clin Experiment Ophthalmol. 2007;35:124–30.PubMed Bhartiya P, Daniell M, Constantinou M, Islam FM, Taylor HR. Fungal keratitis in Melbourne. Clin Experiment Ophthalmol. 2007;35:124–30.PubMed
75.
go back to reference Sponsel WE, Graybill JR, Nevarez HL, Dang D. Ocular and systemic posaconazole(SCH-56592) treatment of invasive Fusarium solani keratitis and endophthalmitis. Br J Ophthalmol. 2002;86:829–30.PubMedCrossRef Sponsel WE, Graybill JR, Nevarez HL, Dang D. Ocular and systemic posaconazole(SCH-56592) treatment of invasive Fusarium solani keratitis and endophthalmitis. Br J Ophthalmol. 2002;86:829–30.PubMedCrossRef
76.
go back to reference Tu EY, McCartney DL, Beatty RF, Springer KL, Levy J, Edward D. Successful treatment of resistant ocular fusariosis with posaconazole (SCH-56592). Am J Ophthalmol. 2007;143:222–7.PubMedCrossRef Tu EY, McCartney DL, Beatty RF, Springer KL, Levy J, Edward D. Successful treatment of resistant ocular fusariosis with posaconazole (SCH-56592). Am J Ophthalmol. 2007;143:222–7.PubMedCrossRef
Metadata
Title
Current Thoughts in Fungal Keratitis: Diagnosis and Treatment
Authors
Zubair Ansari
Darlene Miller
Anat Galor
Publication date
01-09-2013
Publisher
Springer US
Published in
Current Fungal Infection Reports / Issue 3/2013
Print ISSN: 1936-3761
Electronic ISSN: 1936-377X
DOI
https://doi.org/10.1007/s12281-013-0150-1

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