Risk Factors for Contact Lens–Related Fusarium Keratitis

Abstract

Objective: To evaluate the specific contact lensrelated or other factors that may contribute to the outbreak of Fusarium keratitis. Methods: A case-control study was conducted of Fusarium keratitis in contact lens users in Singapore from March 1, 2005, to May 31, 2006, and included 61 patients with Fusarium keratitis and 188 populationbased and 179 hospital-based control subjects. Interviewers asked about contact lens solution use and other risk factors. Results: Patients with Fusarium keratitis were more likely to use ReNu contact lens solutions (Bausch & Lomb, Rochester, NY) 58 [95.1%] of 61 cases) than were either population-based (62 [34.3%] of 181) or hospital-based (50 [30.1%] of 166) control subjects. After controlling for age, sex, contact lens hygiene, and other factors, the use of ReNu with MoistureLoc significantly increased the risk of Fusarium keratitis (odds ratio, 99.3; 95% confidence interval, 18.4-535.4; PϽ.001), and the risk was 5 times higher compared with the risk with use of ReNu MultiPlus, a multipurpose solution (odds ratio, 21.5; 95% confidence interval, 4.0-115.5; PϽ.001). Conclusions: The use of ReNu contact lens solutions significantly increased the risk of contact lens-related Fusarium keratitis in Singapore. Our data support the recall of ReNu MultiPlus from the Singapore market and the need for further investigations into the role of ReNu MultiPlus in the development of Fusarium keratitis in other populations.

Contact lens-related microbial keratitis: how have epidemiology and genetics helped us with pathogenesis and prophylaxis

“…The Fusarium outbreak was initially detected via case series in Singapore 53 and in the United States, 54 and was subsequently described in two case control analyses. 55,56 Independent risk factors are reported in Table 4 and both the studies confirmed the excess risk associated with ReNu MoistureLoc. The solution was recalled worldwide by May 2006.…”

Risk factors for contact lens-related microbial keratitis in Singapore

“…This is consistent with findings in a Singaporean fungal keratitis case-control study that found that Chinese wearers were at a lower risk of developing Fusarium keratitis. 20 A multicentre cross-sectional survey of contact lens complications in Singapore found that 77% of patients who presented with complications were Chinese. 21 However, no disease-free lens wearing controls were included in the published study.…”

Fusarium Infections in Immunocompromised Patients

“…Two recent outbreaks of fusarial keratitis were recently described in the United States (164 cases) and Singapore (66 cases). Case-control studies in the two populations of patients showed that keratitis was more likely to occur in patients who used a specific contact lens solution (ReNu with MoistureLock) (17,98).…”