Indian Journal of Ophthalmology

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

Comments on: Causative fungi and treatment outcome of dematiaceous fungal keratitis in North India


Preetkanwar S Sodhi1, Akash D Goel2, Neelima Sodhi3, Jaswinderpal S Sodhi3,  
1 Department of Vitreo-Retina, Sodhi Eye Hospital, Patiala, Punjab, India
2 Department of Cornea, Tej Kohli Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
3 Department of Ophthalmology, Sodhi Eye Hospital, Patiala, Punjab, India

Correspondence Address:
Dr. Preetkanwar S Sodhi
Department of Vitreo-Retina, Sodhi Eye Hospital, Patiala - 147 001, Punjab
India




How to cite this article:
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;68:952-952


How to cite this URL:
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 [serial online] 2020 [cited 2020 Oct 28 ];68:952-952
Available from: https://www.ijo.in/text.asp?2020/68/5/952/282930


Full Text



Dear Sir,

We would like to congratulate the authors for elaborately reporting dematiaceous fungal keratitis,[1] a lesser documented form in literature. This is one of the largest case series from North India which has reported it.

Although the authors have given an extensive description of the etiology and clinical features, we would like to know about how much was the delay in patient presentation to the authors as it plays an important role in deciding the prognosis and final outcomes. Sengupta et al.[2] reported central location of ulcer to be a statistically related risk factor for analysis of final visual outcome on multivariate analysis. Could the authors find any such factors and whether a univariate and multivariate analysis was performed for the same?

In the reported series, three patients were using topical steroids. We would like to know about how did these patients fare in terms of final visual outcomes, healing and in regards to the surgical management. Also, the treatment protocol mentioned by the authors describes the use of topical natamycin suspension and voriconazole for larger and deeper ulcers.[1] We would like to know if any systemic medication/intra-stromal injections were given for deep seated infections as has been reported by other studies.[2],[3],[4]

Early surgical intervention before the disease becomes advanced has been recommended by Xie et al.[5] Therapeutic penetrating keratoplasty was performed in four eyes by the authors. We would like to know the indications for surgical intervention and according to the authors what is best time to intervene? What was the graft size used by the authors and also the details about post op medication regimen.

We again congratulate the authors and await their reply eagerly.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Kumar 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.
2Sengupta S, Rajan S, Reddy PR, Thiruvengadakrishnan K, Ravindran RD, Lalitha P, et al. Comparative study on the incidence and outcomes of pigmented versus non pigmented keratomycosis. Indian J Ophthalmol 2011;59:291-6.
3Garg P, Gopinathan U, Choudhary K, Rao GN. Keratomycosis: Clinical and microbiologic experience with dematiaceous fungi. Ophthalmology 2000;107:574-80.
4Chowdhary A, Singh K. Spectrum of fungal keratitis in North India. Cornea 2005;24:8-15.
5Xie L, Dong X, Shi W. Treatment of fungal keratitis by penetrating keratoplasty. Br J Ophthalmol 2001;85:1070-4.