The correlation analysis between genera and the prognosis in fungal keratitis

Abstract

Objective To study the relationship between genera and the prognosis in fungal keratitis.Methods Retrospective series case study.A total of 324 cases of fungal keratits from March 2012 to February 2013 in Henan Eye Institute were elected.Slit-lamp examination,corneal smears examination,confocal microscopy,fungal culture and identification were used to diagnose.According to the pathogenic genera,the patients were divided into four groups:fusaria group 172 cases,alternaria group 61 cases,aspergilli group 47 cases and other genera group 44 cases.Follow up the treatment outcomes and record the best corrected visual acuity and the period of treatment of the patients cured by medicines.x2 test,rank sum test and one-way analysis of variance were used to analyze data.Results The surgery rate of fusaria group,aspergilli group,alternaria group and other genera group was 41.3％ (71/172),44.7％ (21/47),6.6％ (4/61) and 11.4％ (5/44) respectively.The differences of the surgery rate among four groups were statistically significant (x2 37.459,P ＜0.001).The surgery rate of fusaria group or aspergilli group was higher than alternaria group or other genera group.The differences of the prognosis among four groups were statistically significant (Hc 38.879,P ＜0.001).The prognosis of fusaria group and aspergilli group was worse than alternaria group and other genera group.Among the patients cured by medicines,the average period of usingdrugs of the patients infected by fusaria,alternaria,aspergilli or other genera was (88±44),(57±30),(68±33) and (59±37)d respectively.The differences of the average period of using drugs among four groups were statistically significant (F 10.221,P ＜0.001).The period of using drugs of the fusaria group was longer than the alternaria group,the aspergilli group and the other genera group.The average recovered visual acuity of the eyes infected by fusaria,aspergilli,alternaria or other genera was 0.65±0.26,0.64±0.26,0.82±0.21 and 0.75±0.27 respectively.The differences of the recovered visual acuity among four groups were statistically significant (F 6.210,P ＜0.001).The recovered visual acuity of the alternaria group was better than the fusaria group and the aspergilli group.Conclusions The prognosis of fungal keratitis caused by fusaria or aspergilli is worse than alternaria or other genera,and has the characteristics of worse effects of drug treatment,lengthier drug treatment,worse recovered visual acuity and higher rate of surgery. Key words: Eye infections; Fungal; Keratitis; Genera; Prognosis