Acute stromal keratitis in clinics – are we missing microsporidia?
Purpose: To report 3 cases of microsporidial stromal keratitis presenting as a diagnostic dilemma to a tertiary eye care center in north India.Methods: Three eyes of 3 patients underwent therapeutic keratoplasty for microsporidial stromal keratitis. A decision for early surgery was taken as the pati...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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German Medical Science GMS Publishing House
2020-02-01
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| Series: | GMS Ophthalmology Cases |
| Subjects: | |
| Online Access: | http://www.egms.de/static/en/journals/oc/2020-10/oc000128.shtml |
| _version_ | 1818317461018116096 |
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| author | Farooqui, Javed Hussain Acharya, Manisha Gandhi, Arpan Mathur, Umang |
| author_facet | Farooqui, Javed Hussain Acharya, Manisha Gandhi, Arpan Mathur, Umang |
| author_sort | Farooqui, Javed Hussain |
| collection | DOAJ |
| description | Purpose: To report 3 cases of microsporidial stromal keratitis presenting as a diagnostic dilemma to a tertiary eye care center in north India.Methods: Three eyes of 3 patients underwent therapeutic keratoplasty for microsporidial stromal keratitis. A decision for early surgery was taken as the patients were not responding to conventional medical management and were worsening clinically. The diagnosis of microsporidia was made by corneal scraping and confirmed on histopathological evaluation of the corneal button.Results: Out of the 3 patients, one maintained a clear graft, one had a recurrence and one had graft rejection, 6 months postoperatively. The patients were not started on steroids in the postoperative period and were given topical antibiotics and polyhexamethylene biguanide (PHMD). Oral Albendazole 400 mg was also given twice a day for a month. Conclusion: Many questions remained unanswered about the management protocol of stromal keratitis caused by microsporidia. The role of topical steroids, antifungal agents, oral Albendazole needs to be discussed. Clinicians should be aware of recurrences which may mimic as rejections. There needs to be more awareness regarding microsporidia as a cause of acute stromal keratitis, so that its not overlooked or underdiagnosed. |
| first_indexed | 2024-12-13T09:37:41Z |
| format | Article |
| id | doaj.art-b629727c43e14a45b9c4f23279be5445 |
| institution | Directory Open Access Journal |
| issn | 2193-1496 |
| language | English |
| last_indexed | 2024-12-13T09:37:41Z |
| publishDate | 2020-02-01 |
| publisher | German Medical Science GMS Publishing House |
| record_format | Article |
| series | GMS Ophthalmology Cases |
| spelling | doaj.art-b629727c43e14a45b9c4f23279be54452022-12-21T23:52:19ZengGerman Medical Science GMS Publishing HouseGMS Ophthalmology Cases2193-14962020-02-0110Doc0110.3205/oc000128Acute stromal keratitis in clinics – are we missing microsporidia?Farooqui, Javed Hussain0Acharya, Manisha1Gandhi, Arpan2Mathur, Umang3Cornea, Cataract and Refractive Surgery, Dr. Shroff’s Charity Eye Hospital, New Delhi, IndiaCornea, Cataract and Refractive Surgery, Dr. Shroff’s Charity Eye Hospital, New Delhi, IndiaLaboratory Services, Dr. Shroff’s Charity Eye Hospital, New Delhi, IndiaCornea, Cataract and Refractive Surgery, Dr. Shroff’s Charity Eye Hospital, New Delhi, IndiaPurpose: To report 3 cases of microsporidial stromal keratitis presenting as a diagnostic dilemma to a tertiary eye care center in north India.Methods: Three eyes of 3 patients underwent therapeutic keratoplasty for microsporidial stromal keratitis. A decision for early surgery was taken as the patients were not responding to conventional medical management and were worsening clinically. The diagnosis of microsporidia was made by corneal scraping and confirmed on histopathological evaluation of the corneal button.Results: Out of the 3 patients, one maintained a clear graft, one had a recurrence and one had graft rejection, 6 months postoperatively. The patients were not started on steroids in the postoperative period and were given topical antibiotics and polyhexamethylene biguanide (PHMD). Oral Albendazole 400 mg was also given twice a day for a month. Conclusion: Many questions remained unanswered about the management protocol of stromal keratitis caused by microsporidia. The role of topical steroids, antifungal agents, oral Albendazole needs to be discussed. Clinicians should be aware of recurrences which may mimic as rejections. There needs to be more awareness regarding microsporidia as a cause of acute stromal keratitis, so that its not overlooked or underdiagnosed.http://www.egms.de/static/en/journals/oc/2020-10/oc000128.shtmlmicrosporidial stromal keratitismicrosporidia |
| spellingShingle | Farooqui, Javed Hussain Acharya, Manisha Gandhi, Arpan Mathur, Umang Acute stromal keratitis in clinics – are we missing microsporidia? GMS Ophthalmology Cases microsporidial stromal keratitis microsporidia |
| title | Acute stromal keratitis in clinics – are we missing microsporidia? |
| title_full | Acute stromal keratitis in clinics – are we missing microsporidia? |
| title_fullStr | Acute stromal keratitis in clinics – are we missing microsporidia? |
| title_full_unstemmed | Acute stromal keratitis in clinics – are we missing microsporidia? |
| title_short | Acute stromal keratitis in clinics – are we missing microsporidia? |
| title_sort | acute stromal keratitis in clinics are we missing microsporidia |
| topic | microsporidial stromal keratitis microsporidia |
| url | http://www.egms.de/static/en/journals/oc/2020-10/oc000128.shtml |
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