Roth, M. and Daas, L. and Renner-Wilde, A. and Cvetkova-Fischer, N. and Saeger, M. and Herwig-Carl, M. and Matthaei, M. and Fekete, A. and Kakkassery, V. and Walther, G. and von Lilienfeld-Toal, M. and Mertens, C. and Lenk, J. and Mehlan, J. and Fischer, C. and Fuest, M. and Kroll, S. and Bayoudh, W. and Viestenz, A. and Frings, A. and MacKenzie, C. R. and Messmer, E. M. and Seitz, B. and Kurzai, O. and Geerling, G. (2019) The German keratomycosis registry. Initial results of a multicenter survey. OPHTHALMOLOGE, 116 (10). pp. 957-966. ISSN 0941-293X, 1433-0423
Full text not available from this repository. (Request a copy)Abstract
Background and purpose. Mycotic keratitis is a serious but relatively rare disease. No targeted data collection in Germany existed until the foundation of the German Pilz-Keratitis Register in 2015. Patients and methods. The inclusion of retrospective and prospective patients was carried out. Inclusion criteria: diagnosis confirmed by the polymerase chain reaction (PCR), culture, histology or confocal microscopy (IVCM). Collected parameters: date of symptom onset, date and method of diagnosis, risk factors, visual acuity and findings at admission and at follow-up, conservative and surgical treatment. Results. By January 2018, a total of 102 eyes from the years 2000-2017 were reported from 16 centers (64.3% female, mean age 52 years, range 18-95 years). The initial diagnosis was made correctly in only 20.6% of cases. The mean time to correct diagnosis was 31.7 +/- 46.9 (0-296) days. The diagnosis was confirmed in cultures in 74.5%, histologically in 30.4%, by PCR in 38.2% and IVCM in 27.4%. Fungal species identified were: 36.7% Fusarium spp., 35.8% Candida spp., 6.4% Aspergillus spp. and 21.1% other. The most important risk factor was the use of contact lenses. The most commonly used antifungal agent was voriconazole (64.7%) followed by amphotericin B (37.2%). Penetrating keratoplasty was performed in 65.7% of the cases and 8.8% of the affected eyes had to be enucleated. The visual acuity of the entire study population increased from the initial 0.16 +/- 0.25 (0.001-1.0) decimal to 0.28 +/- 0.34 (0-1.0) decimal. Conclusion. The correct diagnosis of fungal keratitis is often significantly delayed. The treatment can be very difficult and keratoplasty is often necessary. In order to gain a better understanding of this disease, to recognize previously unknown risk factors and, if necessary, a change in the spectrum of pathogens and to identify approaches to treatment optimization, the fungal keratitis registry will be continued.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | FUNGAL KERATITIS; RISK-FACTORS; MICROBIAL KERATITIS; CROSS-LINKING; DIAGNOSIS; VORICONAZOLE; OUTCOMES; THERAPY; LONDON; TRENDS; Infection; Mycosis; Fusarium; Candida; Cornea |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Augenheilkunde |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 25 Mar 2020 13:52 |
| Last Modified: | 25 Mar 2020 13:52 |
| URI: | https://pred.uni-regensburg.de/id/eprint/26034 |
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