Indian Journal of Ophthalmology

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


Ajit Kumar1, Ashi Khurana1, Mohit Sharma2, Lokesh Chauhan3,  
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

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




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;68:952-953


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 2024 Mar 29 ];68:952-953
Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?2020/68/5/952/282889


Full Text



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}

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

1Sodhi 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.
2Kumar 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.