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LETTER TO THE EDITOR
Year : 2020  |  Volume : 68  |  Issue : 5  |  Page : 952-953

Response to comments on: Causative fungi and treatment outcome of Dematiaceous fungal keratitis in North India


1 Department of Cornea and Refractive Error, C L Gupta Eye Institute, Moradabad, Uttar Pradesh, India
2 Department of Microbiology, C L Gupta Eye Institute, Moradabad, Uttar Pradesh, India
3 Department of Clinical Research, C L Gupta Eye Institute, Moradabad, Uttar Pradesh, India

Date of Web Publication20-Apr-2020

Correspondence Address:
Dr. Ajit Kumar
Department of Cornea and Refractive Error, C L Gupta Eye Institute, Ram Ganga Vihar, Phase 2 (Ext) Moradabad - 244 001, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_360_20

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How to cite this article:
Kumar A, Khurana A, Sharma M, Chauhan L. Response to comments on: Causative fungi and treatment outcome of Dematiaceous fungal keratitis in North India. Indian J Ophthalmol 2020;68:952-3

How to cite this URL:
Kumar A, Khurana A, Sharma M, Chauhan L. Response to comments on: Causative fungi and treatment outcome of Dematiaceous fungal keratitis in North India. Indian J Ophthalmol [serial online] 2020 [cited 2020 May 26];68:952-3. Available from: http://www.ijo.in/text.asp?2020/68/5/952/282889



Dear Sir,

We thank Sodhi et al.[1] for their interest and comments on our article "Causative fungi and treatment outcome of Dematiaceous fungal keratitis in North India."[2] To answer the queries raised: the mean delay in patient presentation was 13.5 ± 14.5 days (95% confidence interval: 10.3–16.7 days; range: 1–90 days). Final visual acuity of patients with central location of ulcer was 0.96 ± 0.76 logMAR and of patients with paracentral/peripheral (combined as other group) ulcers was 0.51 ± 0.7 logMAR (P = 0.04; Independent sample t-test). In our study, the presence of hypopyon was associated with worse visual outcome [Table 1]. This univariate analysis was not presented in original article.
Table 1: Univariate analysis of identified risk factors' analysis for predicting visual outcome

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Final visual acuity of the 3 patients using steroids at presentation was 20/20 in one case, 20/200 in second case. One patient was lost to follow-up. None of these patients required surgical management.

Indications for therapeutic penetrating keratoplasty were total infiltrate threatening to involve the limbus, corneal perforation of >2 mm, and infiltrate not responding to intensive medication for 1-2 weeks. Graft size used was 9 mm in two cases, 10 mm in one case, and 11 mm in one case. Postoperatively, topical antifungals, cycloplegics, and analgesics were started for 2 weeks; after that, if there was no recurrence of infiltrate, steroids were started with discontinuation of antifungal therapy. We did not use intrastromal injections or oral antifungals. We saw a good response with topical therapy in the majority of cases. Hence, we do not suggest very early surgical intervention unless indicated.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sodhi PS, Goel AD, Sodhi N, Sodhi JS. Comments on: Causative fungi and treatment outcome of dematiaceous fungal keratitis in North India. Indian J Ophthalmol 2020;68:952.  Back to cited text no. 1
  [Full text]  
2.
Kumar A, Khurana A, Sharma M, Chauhan L. Causative fungi and treatment outcome of dematiaceous fungal keratitis in North India. Indian J Ophthalmol 2019;67:1048-53.  Back to cited text no. 2
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