Predictors of the need for surgery in keratitis due to Fusarium spp. at Rossi Hospital of La Plata, Argentina

Abstract

Purpose: To determine the prevalence of keratitis due to Fusarium spp. and to identify the clinical features and sociodemographic factors related to the indication for penetrating keratoplasty (PK) in our region.
Methods: Retrospective, observational and analytic study in patients with keratitis due to Fusarium spp. who underwent PK or not between December 2008 and July 2019. Information from medical records was reviewed for the verification of the sociodemographic (age, gender, occupation and history of risk factors such as trauma, contact lens use or keratitis caused by herpes virus) and clinical characteristics (evolution time, visual acuity, abscess size, presence of hypopyon) observed on the first visit.
Results: A total of 440 samples of corneal abscesses, of which 25 were positive for Fusarium spp., were evaluated. Of these patients, 10 (40%), all of them of male gender and an average age of 38 years, underwent emergency PK. Factors most commonly associated with PK were: abscess size larger than 4 mm (95% CI, 1.52 - 8.01, p = 0.0001), presence of hypopyon (95% CI, 1.41 - 5.02, p = 0.002) and poor baseline visual acuity (95% CI, 1.10 - 5.83, p = 0.009).
Conclusions: Prediction factors strongly associated with worse prognosis or with a greater risk of need for surgery were successfully evidenced. Their identification would be very helpful to the general ophthalmologist when it comes to timely referring the patient to centers of greater complexity, thereby improving their final visual prognosis.