| Dokumentenart: | Artikel | ||||
|---|---|---|---|---|---|
| Titel eines Journals oder einer Zeitschrift: | Der Ophthalmologe | ||||
| Verlag: | SPRINGER HEIDELBERG | ||||
| Ort der Veröffentlichung: | HEIDELBERG | ||||
| Band: | 116 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 10 | ||||
| Seitenbereich: | S. 957-966 | ||||
| Datum: | 2019 | ||||
| Institutionen: | Medizin > Lehrstuhl für Augenheilkunde | ||||
| Identifikationsnummer: |
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| Stichwörter / Keywords: | FUNGAL KERATITIS; RISK-FACTORS; MICROBIAL KERATITIS; CROSS-LINKING; DIAGNOSIS; VORICONAZOLE; OUTCOMES; THERAPY; LONDON; TRENDS; Infection; Mycosis; Fusarium; Candida; Cornea | ||||
| Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status: | Veröffentlicht | ||||
| Begutachtet: | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden: | Ja | ||||
| Dokumenten-ID: | 48157 |
Web of ScienceZusammenfassung
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 ...
Zusammenfassung
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.
Metadaten zuletzt geändert: 03 Sep 2021 09:42
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