Reflexões sobre a ceratite fúngica por meio dos achados de exames histopatológicos

Monte, Fernando Queiroz; Stadtherr, Niedja Marques

doi:10.1590/s0034-72802013000200003

Cited by 3 publications

(4 citation statements)

References 27 publications

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“…Filamentous fungi proliferate in the corneal stroma not releasing any chemotaxic substances, which again delays the development of the immune response. In case of the disease progression, fungi pass through the previously intact Descemet membrane [ 42 , 62 ]. Moreover, fungal keratitis may occur secondary to fungal endophthalmitis.…”

Section: Pathogenesismentioning

confidence: 99%

Modern Technologies in Diagnosis of Fungal Keratitis (Review)

Sitnova¹,

Svetozarskiy²

2023

Sovrem Tehnol Med

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Traumas and infectious diseases of the eye play a leading role in the development of corneal blindness responsible for 1.5–2 million cases of vision loss per year. To date, the issue of reducing the incidence of fungal keratitis is acute and needs to be solved worldwide. Trauma as a risk factor for corneal fungal disease is thought to be prevalent in developing countries due to agricultural involvement, while in developed countries the onset of the disease is predisposed by medical advances such as contact vision correction and modern ophthalmic surgery. Thorough analysis of the pathogenesis gives the possibility to describe the action of fungal enzymes, biofilm formation, and the resistance mechanism, which on the one hand explains the aggressive course of the disease and difficulties in its diagnosis, and on the other hand, it encourages searching for new methods of diagnosis and treatment. The non-specific clinical picture of fungal keratitis, the variety and availability of antibiotics nowadays become an obstacle for rapid detection of this pathology. Low public awareness and late visit to an ophthalmologist are also a barrier to successful combating the increasing incidence of fungal keratitis. Belated diagnosis, increasing resistance of fungi to antibiotics, and lack of registered antifungal ophthalmic drugs justify poor treatment efficacy resulting in decreased visual acuity or vision loss . Existing diagnostic methods need systematization and detailed comparison, identifying the advantages and disadvantages of each. This review considers causative agents and their influence on pathogenesis of the disease, describes difficulties of fungal keratitis diagnosis and possible ways of overcoming these problems using new developments, and also outlines further prospects of research in this direction.

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Section: Pathogenesismentioning

confidence: 99%

Modern Technologies in Diagnosis of Fungal Keratitis (Review)

Sitnova¹,

Svetozarskiy²

2023

Sovrem Tehnol Med

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“…В то же время отмечается, что в пределах одного рода разные виды грибов могут иметь разный характер роста [12]. Нитчатые грибы способны перфорировать интактную десцеметову оболочку [7,13]. После этого формируется единый комплекс «хрусталик -радужка -грибковый агент» в области зрачка.…”

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“…Поэтому травма является основным предрасполагающим фактором грибкового кератита, который отмечается у 40-60 % пациентов [30,31]. Травма может носить вторичный характер, например у пользователей контактными линзами [30] или после предшествующих оперативных вмешательств на глазах [13]. Травматические факторы растительного и животного происхождения (в том числе частицы пыли) или напрямую внедряются в строму роговицы, или способствуют истиранию эпителия роговицы, обеспечивая проникновение грибковых агентов [32][33][34].…”

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Pathogenesis and Clinical Features of Fungal Keratitis (Review)

Belskaia

Obrubov

2021

Oftalʹmologiâ

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In this review we presented the information about pathogenesis of mycotic keratitis and the most characteristic clinical signs that can help ophthalmologists to suspect mycotic etiology. In conditions of poor accessibility and informativeness of laboratory and instrumental diagnostic tests, the analysis of the anamnesis and the clinical signs remain the only information that can be used by a physician while making a diagnosis and choosing treating strategies. This review contains the results of a number of studies. In the review we show the progression phases of cornea mycotic infection, among them adherence, invasion, morphogenesis and toxigenicity. We also reveal that the most characteristic clinical signs of mycotic keratitis are scalloped rough edge of stromal defect, prominent dry crumby or caseous structured view of infiltrates and necrotic masses, satellite infiltrates, certain changes of color of the defected area. Heaviness of mycotic keratitis ulcer defect has a correlation with an unfavourable prognosis for disease. Mycotic keratitis during contagion can be complicated by mycotic glaucoma with a malignant disease course and endophthalmitis. There can be cases with mixed infection. While Almost No clinical sign is pathognomonic for keratomycoses, summing up all the signs can verify the diagnosis. Ophthalmologists need training in the recognition the clinical signs of infectious keratitis. Also new methods of fast diagnostics of infectious keratitis etiology and implementation on a large scale are needed.

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Non-viral microbial keratitis in adults: clinical and laboratory aspects

Cury

Chang

Pontes

2018

Brazilian Journal of Microbiology

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This study compares patients with and without non-viral microbial keratitis in relation to sociodemographic variables, clinical aspects, and involved causative agent. Clinical aspects, etiology and therapeutic procedures were assessed in patients with and without keratitis that were diagnosed in an Eye Care Center in Campo Grande, MS, Brazil. Patients were divided into two groups: (a) cases: 64 patients with non-viral microbial keratitis diagnosed at biomicroscopy; and (b) controls: 47 patients with other eye disorders that were not keratitis. Labor activity related to agriculture, cattle raising, and contact lens use were all linked to keratitis occurrence (p<0.005). In patients with keratitis, the most common symptoms were pain and photophobia, and the most frequently used medicines were fourth-generation fluoroquinolones (34.4%), amphotericin B (31.3%), and natamycin (28.1%). Microbial keratitis evolved to corneal perforation in 15.6% of cases; transplant was indicated in 10.9% of cases. Regarding the etiology of this condition, 23 (42.2%) keratitis cases were caused by bacteria (Pseudomonas aeruginosa, 12.5%), 17 (39.1%) by fungi (Fusarium spp., 14.1% and Aspergillus spp., 4.7%), and 4 (6.3%) by Acanthamoeba. Patients with keratitis present with a poorer prognosis. Rapid identification of the etiologic agent is indispensable and depends on appropriate ophthalmological collection and microbiological techniques.

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Reflexões sobre a ceratite fúngica por meio dos achados de exames histopatológicos

Cited by 3 publications

References 27 publications

Modern Technologies in Diagnosis of Fungal Keratitis (Review)

Modern Technologies in Diagnosis of Fungal Keratitis (Review)

Pathogenesis and Clinical Features of Fungal Keratitis (Review)

Non-viral microbial keratitis in adults: clinical and laboratory aspects

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