Roth, M., Daas, L., Renner-Wilde, A., Cvetkova-Fischer, N., Saeger, M., Herwig-Carl, M., Matthaei, M., Fekete, A., Kakkassery, V., Walther, G., von Lilienfeld-Toal, M., Mertens, C., Lenk, J., Mehlan, J., Fischer, C., Fuest, M., Kroll, S., Bayoudh, W., Viestenz, A., Frings, A., MacKenzie, C. R., Messmer, E. M., Seitz, B., Kurzai, O. and Geerling, G. (2019). The German keratomycosis registry. Initial results of a multicenter survey. Ophthalmologe, 116 (10). S. 957 - 967. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0423

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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: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Roth, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Daas, L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Renner-Wilde, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cvetkova-Fischer, N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Saeger, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herwig-Carl, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Matthaei, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fekete, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kakkassery, V.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Walther, G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Lilienfeld-Toal, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mertens, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lenk, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mehlan, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fischer, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fuest, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kroll, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bayoudh, W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Viestenz, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Frings, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
MacKenzie, C. R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Messmer, E. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seitz, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kurzai, O.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Geerling, G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-131602
DOI: 10.1007/s00347-019-0871-9
Journal or Publication Title: Ophthalmologe
Volume: 116
Number: 10
Page Range: S. 957 - 967
Date: 2019
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1433-0423
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
FUNGAL KERATITIS; RISK-FACTORS; MICROBIAL KERATITIS; CROSS-LINKING; DIAGNOSIS; VORICONAZOLE; OUTCOMES; THERAPY; LONDON; TRENDSMultiple languages
OphthalmologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/13160

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