Authors′ reply

Nath, Reema; Saikia, Lahari; Borthakur, AchintaK; Baruah, Syamanta; Devi, Bhanu; Mahanta, Jagadish

doi:10.4103/0301-4738.98733

Cited by 14 publications

(29 citation statements)

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“…Regarding gender distribution, a male preponderance was also reported by M Jayahar Bharathi et al, [7] Reema Nath et al, [9] Prajna Lalitha et al [10] in their studies (65.02%, 67.6% and 55.6% respectively).…”

Section: Discussionsupporting

confidence: 54%

Factors Responsible for Poor Visual Outcome in Fungal Keratitis

Choudhary¹,

Lakhtakia²,

Chalisgoankar³

et al. 2015

jemds

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Infectious keratitis is a potentially sight threatening ocular condition and about, 44% of all central corneal ulcers are caused by fungi. Fungal keratitis is more common in warmer climates and rural areas and often follows trauma to the cornea especially by organic vegetative matter or objects contaminated by soil. Application of topical steroid drops, TEM use and other predisposing factors often leads to an exacerbation of infection, affecting final visual acuity. These factors coupled with delay in presentation as symptoms are less compared to signs, further affects the visual outcome. The present study evaluated the incidence of fungal keratitis in relation to age, sex, occupation and season in a hospital based population and also to identify risk affecting the visual outcome. Incidence of fungal keratitis cases was maximum in 41-60 years, and more common in males, illiterate persons, and those belonging to low socio economic status. It was more common in farmers and the factors affecting the final visual outcome included patients aged more than 40 years (p<0.05) and those presenting after 7 days (p<0.05), with history of topical steroid (p<0.05) use had a significantly poorer visual outcome. Similarly patients with central ulcers (p<0.05), especially those associated with hypopyon (p<0.05%) also had a significantly less favourable visual outcome. However, use of TEM and type of fungal infection were not significantly related to poor outcome in terms of visual acuity.

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Section: Discussionsupporting

confidence: 54%

Factors Responsible for Poor Visual Outcome in Fungal Keratitis

Choudhary¹,

Lakhtakia²,

Chalisgoankar³

et al. 2015

jemds

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“…They may account for more than 50% of all culture-positive microbial keratitis especially in tropical and sub-tropical countries [129,196,213]. A strong geograph ical correlation has been reported to exist between the occurrences of different types of keratomycosis.…”

Section: Mycotic Keratitismentioning

confidence: 99%

“…However Candida albicans and other Candida species are most common keratitis-causing yeast-like fungi. Former is reported to be due to ocular trauma which is usually the most important predisposing factor in healthy young males engaged in agricultural or other outdoor activities [53,129,196]. These fungi do not invade the intact cornea and penetration only occurs once the epithelium is abraded.…”

Section: Mycotic Keratitismentioning

confidence: 99%

“…These fungi do not invade the intact cornea and penetration only occurs once the epithelium is abraded. Traumatizing agents of animal origin or vegetative matter, soil or dust particle either directly implant fungal conidia on abraded corneal epithelium for fungal invasion [53,129,196]. The use of corticosteroids, ocular surgery, ocular surface disease and contact lens wear has now also been increasingly identified as a significant risk factor.…”

Section: Mycotic Keratitismentioning

confidence: 99%

“…Damage to the cornea results in the upregulation of mannose glycoproteins on the corneal surface [29]; it may therefore play an important role in the adhesion and pathogenesis of fungal keratitis. Ocular trauma is the most important pre-disposing factor in mycotic keratitis [53,129,196]; the absence of which prevents fungal penetration into the cornea. Thus, the correla tion of ocular trauma with an increased expression of mannose glycoproteins on the corneal surface and presence of adhesive mannoproteins on the surface of fungal cell wall is likely involved in the pathophysiology of fungal keratitis.…”

Section: Adhesionmentioning

confidence: 99%

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Pathogenesis of microbial keratitis

Lakhundi

Siddiqui

Khan

2017

Microbial Pathogenesis

171

121

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Microbial keratitis is a sight-threatening ocular infection caused by bacteria, fungi, and protist pathogens. Epithelial defects and injuries are key predisposing factors making the eye susceptible to corneal pathogens. Among bacterial pathogens, the most common agents responsible for keratitis include Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumonia and Serratia species. Fungal agents of corneal infections include both filamentous as well as yeast, including Fusarium, Aspergillus, Phaeohyphomycetes, Curvularia, Paecilomyces, Scedosporium and Candida species, while in protists, Acanthamoeba spp. are responsible for causing ocular disease. Clinical features include redness, pain, tearing, blur vision and inflammation but symptoms vary depending on the causative agent. The underlying molecular mechanisms associated with microbial pathogenesis include virulence factors as well as the host factors that aid in the progression of keratitis, resulting in damage to the ocular tissue. The treatment therefore should focus not only on the elimination of the culprit but also on the neutralization of virulence factors to minimize the damage, in addition to repairing the damaged tissue. A complete understanding of the pathogenesis of microbial keratitis will lead to the rational development of therapeutic interventions. This is a timely review of our current understanding of the advances made in this field in a comprehensible manner. Coupled with the recently available genome sequence information and high throughput genomics technology, and the availability of innovative approaches, this will stimulate interest in this field.

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