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2023 OMIG Abstract

Trends and Clinical Outcomes of Fungal Keratitis in Canada: a 20-year Retrospective Multicentre Study

Jennifer YM Ling¹, Sonia N Yeung¹, Clara Chan², Tanya Trinh^2,3, Fares Antaki⁴, Mona Harissi Dagher⁴, Nirojini Sivachandran⁵, Mark Fava⁵, Marie Eve Legare⁶, and Alfonso Iovieno<sup>1

1</sup>University of British Columbia, Department of Ophthalmology and Visual Sciences, Vancouver, British Columbia, Canada; ²University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto, Ontario, Canada; ³Sydney Eye Hospital, Sydney, Australia; ⁴Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada; ⁵McMaster University, Division of Ophthalmology, Hamilton, Ontario, Canada; ⁶Centre Universitaire d'Ophtalmologie - CHU de Québec, Université Laval, Québec City, Québec, Canada

Purpose: An increase in fungal and particularly filamentous keratitis has been observed in many geographic areas, mostly in contact lens wearers. This study seeks to characterize long-term trends in fungal keratitis in a temperate and continental climate area to provide guidance for diagnosis and treatment.

Methods: This retrospective review included cases of microbiology-confirmed cases of fungal keratitis from 2003 to 2022 presenting to tertiary care centers across Canada. Charts were reviewed for patient demographics, risk factors, visual acuity, and treatments undertaken.

Results: A total of 138 patients were identified: 73 had filamentous keratitis while 65 had yeast keratitis. Patients with yeast keratitis had more ocular surface disease (79% vs 28%) and were more likely to manipulate their bandage contact lenses (36% vs 6%), while patients with filamentous keratitis wore more refractive contact lenses (78% vs 19%). Candida species accounted for 96% of all yeast identified, while Aspergillus (32%) and Fusarium (26%) were the most common filamentous fungi species. The mean duration of treatment was 81 ± 96 days. Patients with yeast keratitis did not have significantly improved visual acuity with medical treatment (1.8 ± 1 LogMAR to 1.9 ± 1.5 LogMAR, p = 0.9980), in contrast to patients with filamentous keratitis (1.4 ± 1.2 LogMAR to 1.1 ± 1.3 LogMAR, p = 0.0093).

Conclusions: Fungal keratitis is increasingly common, with contact lenses emerging as one of the leading risk factors. Significant differences in the risk factors and visual outcomes exist between yeast keratitis and filamentous keratitis which may guide diagnosis and treatment.

Disclosure: N

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