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2020 OMIG Abstract

Pythium Keratitis: Outcome and Prognostic Factors

Bhupesh Bagga, FRCS¹, Anahita Kate, MD¹, Savitri Sharma, MD², Ashik Mohamed, PhD^3
1The Cornea Institute, L V Prasad Eye Institute, Hyderabad, India; ²Jhaveri Microbiology Centre, LV Prasad Eye Institute, Hyderabad, India; Cornea Institute, ³Biophysics, L V Prasad Eye Institute, Hyderabad, India

Methods: Retrospective analysis of 69 cases with microbiologically confirmed Pythium keratitis, managed between January 2017 to October 2018, was performed. All cases had been treated with topical linezolid 0.2 % ophthalmic solution and topical azithromycin 1% or ointment 1% along with Oral azithromycin 500 mg.

Results: The mean age was 38.4+14.7 years and median logMAR visual acuity was 2.78 (1.20-3.00). Average size of the infiltrate was 5.5x5.6 mm. Out of 69 cases, 37/69 (53.6%) cases showed clinical resolution. Median duration of resolution of keratitis with medical treatment was 3 (IQR, 2-4) months. Median LogMAR final visual acuity improved to 0.80 (IQR, 0.40-1.60). While posterior stromal involvement was associated with worse outcome (p=0.04), presence of pinhead lesions surrounding the infiltrate (P=0.04) and plaque like infiltrate (P=0.16) were associated with successful outcome. Therapeutic keratoplasty was needed in 32/69 (46.3%) cases either for tectonic support in a responding keratitis or for worsening of infection. None of the case had any residual or recurrence of infection after keratoplasty.

Conclusion: This case series has provided evidence regarding the potential role of antibiotics in the management of Pythium insidiosum keratitis and highlighted features for prognostication of the disease.

Disclosure: N

Support: Hyderabad Eye Research Foundation

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