Epidemiological profile of fungal keratitis in urban population of West Bengal, India

Background : Corneal diseases are one of the major causes of visual loss and blindness, second only to cataract. Amongst corneal diseases, microbial keratitis is a major blinding disease. In some countries, fungal keratitis accounts for almost 50% of patients with culture-proven microbial keratitis....

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Main Authors: Suman Saha, Debdulal Banerjee, Archana Khetan, Jayangshu Sengupta
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2009-01-01
Series:Oman Journal of Ophthalmology
Subjects:
Online Access:http://www.ojoonline.org/article.asp?issn=0974-620X;year=2009;volume=2;issue=3;spage=114;epage=118;aulast=Saha
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author Suman Saha
Debdulal Banerjee
Archana Khetan
Jayangshu Sengupta
author_facet Suman Saha
Debdulal Banerjee
Archana Khetan
Jayangshu Sengupta
author_sort Suman Saha
collection DOAJ
description Background : Corneal diseases are one of the major causes of visual loss and blindness, second only to cataract. Amongst corneal diseases, microbial keratitis is a major blinding disease. In some countries, fungal keratitis accounts for almost 50% of patients with culture-proven microbial keratitis. Aim : This study was conducted to determine the epidemiological characteristics of fungal keratitis in an urban population of West Bengal and identify the specific pathogenic organisms. Methods : The charts of patients with microbial keratitis who attended the Cornea Services of Priyamvada Birla Aravind Eye Hospital from January to December 2008 were retrospectively reviewed. Records of patients with 10% KOH mount and culture positive fungal keratitis were analyzed for epidemiological features, laboratory findings and treatment outcomes. Results : Of the 289 patients of microbial keratitis included in the study, 110 patients (38.06%) were diagnosed with fungal keratitis (10% KOH mount positive). Of the 110 patients, 74 (67.27%) fitted the study inclusion criteria (10% KOH mount and culture positive). Forty five of 74 patients (60.81%) in the study group were in the older age group (>50 years). Ocular trauma in 35 cases (47.29%) was identified as a high risk factor and vegetative injuries in 17 cases (22.97%) were identified as a significant cause for fungal keratitis. Maximum organism source was from corneal scrapings in 41 cases (55%). The predominant fungal species isolated was Aspergillus sp (55.40%) followed by Candida albicans 14 cases (18.91%) and Fusarium sp. in 8 cases (10.81%). Agricultural activity related ocular trauma was the principal cause of mycotic keratitis and males were more commonly affected. Thirty of 74 cases (40.55%) of the culture positive patients healed with corneal scar formation with medical treatment whereas 44 cases (59.45%) required therapeutic keratoplasty. Conclusion : Fungal keratitis is an important cause of microbial keratitis with injury to the cornea being a leading predisposing factor. Although Aspergillus sp. was implicated in most of the patients in our study population, Candida sp. were found in higher numbers than previously reported. Keratitis caused by filamentous fungi responds adequately to medical management. Therapeutic keratoplasty continues to remain an important treatment modality in infections with Candida sp. Early diagnosis with prompt identification of the pathogenic organism is mandatory to initiate appropriate therapy and thereby reduce morbidity.
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spelling doaj.art-8a18fc1c380e4fd4aef0b2a4d5d92ecd2022-12-22T03:14:42ZengWolters Kluwer Medknow PublicationsOman Journal of Ophthalmology0974-620X2009-01-012311411810.4103/0974-620X.57310Epidemiological profile of fungal keratitis in urban population of West Bengal, IndiaSuman SahaDebdulal BanerjeeArchana KhetanJayangshu SenguptaBackground : Corneal diseases are one of the major causes of visual loss and blindness, second only to cataract. Amongst corneal diseases, microbial keratitis is a major blinding disease. In some countries, fungal keratitis accounts for almost 50% of patients with culture-proven microbial keratitis. Aim : This study was conducted to determine the epidemiological characteristics of fungal keratitis in an urban population of West Bengal and identify the specific pathogenic organisms. Methods : The charts of patients with microbial keratitis who attended the Cornea Services of Priyamvada Birla Aravind Eye Hospital from January to December 2008 were retrospectively reviewed. Records of patients with 10% KOH mount and culture positive fungal keratitis were analyzed for epidemiological features, laboratory findings and treatment outcomes. Results : Of the 289 patients of microbial keratitis included in the study, 110 patients (38.06%) were diagnosed with fungal keratitis (10% KOH mount positive). Of the 110 patients, 74 (67.27%) fitted the study inclusion criteria (10% KOH mount and culture positive). Forty five of 74 patients (60.81%) in the study group were in the older age group (>50 years). Ocular trauma in 35 cases (47.29%) was identified as a high risk factor and vegetative injuries in 17 cases (22.97%) were identified as a significant cause for fungal keratitis. Maximum organism source was from corneal scrapings in 41 cases (55%). The predominant fungal species isolated was Aspergillus sp (55.40%) followed by Candida albicans 14 cases (18.91%) and Fusarium sp. in 8 cases (10.81%). Agricultural activity related ocular trauma was the principal cause of mycotic keratitis and males were more commonly affected. Thirty of 74 cases (40.55%) of the culture positive patients healed with corneal scar formation with medical treatment whereas 44 cases (59.45%) required therapeutic keratoplasty. Conclusion : Fungal keratitis is an important cause of microbial keratitis with injury to the cornea being a leading predisposing factor. Although Aspergillus sp. was implicated in most of the patients in our study population, Candida sp. were found in higher numbers than previously reported. Keratitis caused by filamentous fungi responds adequately to medical management. Therapeutic keratoplasty continues to remain an important treatment modality in infections with Candida sp. Early diagnosis with prompt identification of the pathogenic organism is mandatory to initiate appropriate therapy and thereby reduce morbidity.http://www.ojoonline.org/article.asp?issn=0974-620X;year=2009;volume=2;issue=3;spage=114;epage=118;aulast=SahaCandida sp.fungal keratitistherapeutic keratoplasty
spellingShingle Suman Saha
Debdulal Banerjee
Archana Khetan
Jayangshu Sengupta
Epidemiological profile of fungal keratitis in urban population of West Bengal, India
Oman Journal of Ophthalmology
Candida sp.
fungal keratitis
therapeutic keratoplasty
title Epidemiological profile of fungal keratitis in urban population of West Bengal, India
title_full Epidemiological profile of fungal keratitis in urban population of West Bengal, India
title_fullStr Epidemiological profile of fungal keratitis in urban population of West Bengal, India
title_full_unstemmed Epidemiological profile of fungal keratitis in urban population of West Bengal, India
title_short Epidemiological profile of fungal keratitis in urban population of West Bengal, India
title_sort epidemiological profile of fungal keratitis in urban population of west bengal india
topic Candida sp.
fungal keratitis
therapeutic keratoplasty
url http://www.ojoonline.org/article.asp?issn=0974-620X;year=2009;volume=2;issue=3;spage=114;epage=118;aulast=Saha
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AT debdulalbanerjee epidemiologicalprofileoffungalkeratitisinurbanpopulationofwestbengalindia
AT archanakhetan epidemiologicalprofileoffungalkeratitisinurbanpopulationofwestbengalindia
AT jayangshusengupta epidemiologicalprofileoffungalkeratitisinurbanpopulationofwestbengalindia