The Significance of Repeat Cultures in the Treatment of Severe Fungal Keratitis (original) (raw)

American journal of ophthalmology, 2018

Abstract

To identify fungal keratitis patients who are at risk of a poor outcome and may benefit from closer follow-up or more aggressive treatment. Secondary analysis of randomized clinical trial data. Patients presenting with a smear-positive filamentous fungal ulcer, visual acuity of 20/400 or worse, and who subsequently had a 6-day fungal culture performed at the Aravind Eye Care system (India), Lumbini Eye Hospital (Nepal), or Bharatpur Eye Hospital (Nepal). We compare the clinical outcomes of patients who had positive 6-day fungal cultures compared to those who did not, using backwards-stepwise regression with co-variates for all baseline clinical characteristics. The primary outcome is rate of corneal perforation and/or the need for therapeutic penetrating keratoplasty. Secondary outcomes include 3-month best spectacle corrected visual acuity (BSCVA), 3-month infiltrate and/or scar-size, and rate of re-epithelialization. Patients who tested positive at their 6-day culture had twice th...

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