Fungal corneal ulcer complicated by endophthalmitis: clinical and laboratory diagnostics, treatment tactics
Purpose: to study the clinical signs and effectiveness of laboratory diagnostics of fungal corneal ulcer complicated by endophthalmitis aimed at treatment tactics optimization.Materials and methods. 15 patients aged 20–55 with severe monocular fungal ulcer complicated by endophthalmitis were examine...
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| Format: | Article |
| Language: | Russian |
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Real Time Ltd
2022-03-01
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| Series: | Российский офтальмологический журнал |
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| Online Access: | https://roj.igb.ru/jour/article/view/882 |
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| author | L. A. Kovaleva G. I. Krichevskaya P. V. Maкarov A. O. Petrova S. V. Flora I. D. Zyurnyayeva A. E. Andryushi O. I. Markelova |
| author_facet | L. A. Kovaleva G. I. Krichevskaya P. V. Maкarov A. O. Petrova S. V. Flora I. D. Zyurnyayeva A. E. Andryushi O. I. Markelova |
| author_sort | L. A. Kovaleva |
| collection | DOAJ |
| description | Purpose: to study the clinical signs and effectiveness of laboratory diagnostics of fungal corneal ulcer complicated by endophthalmitis aimed at treatment tactics optimization.Materials and methods. 15 patients aged 20–55 with severe monocular fungal ulcer complicated by endophthalmitis were examined by microscopy and culture of corneal scraping on Sabouraud Agar; microscopy and culture of intraocular fluid and corneal fragments, obtained during the surgical treatment. Corneal scrapings from the corneal ulcer and corneal fragments removed during keratoplasty were tested in polymerase chain reaction (PCR) for the presence of deoxyribonucleic acid (DNA) of Candida albicans and total Fungi DNA.Results. Before treatment start, 2.5 hours after the biomaterial was taken, PCR revealed Fungi DNA in all 15 cases. Symptoms of the severe fungal corneal ulcer complicated by endophthalmitis and caused by Aspergillus spp have been identified and described. Conservative therapy and total penetrating keratoplasty (PKP) helped retain the eye in 13 out of 15 patients (86.7 %) and partially restore the visual functions.Conclusion. Rapid laboratory diagnosis of ophthalmomycosis using PCR offers an advantage over the culturing technique: the results are ready within 2.5 hours instead of 10-14 days (culture method); it is highly sensitive and allows identifying the fungi not only in the tissue of the removed cornea, but also in the сorneal scrapings. The effective treatment tactics of fungal corneal ulcer complicated by endophthalmitis combining PKP with pre-operative and long-term postoperative antifungal therapy was proposed. |
| format | Article |
| id | doaj-art-b484a87391ac41f69920bd6945cba529 |
| institution | DOAJ |
| issn | 2072-0076 2587-5760 |
| language | Russian |
| publishDate | 2022-03-01 |
| publisher | Real Time Ltd |
| record_format | Article |
| series | Российский офтальмологический журнал |
| spelling | doaj-art-b484a87391ac41f69920bd6945cba5292025-08-20T03:19:24ZrusReal Time LtdРоссийский офтальмологический журнал2072-00762587-57602022-03-01151192410.21516/2072-0076-2022-15-1-19-24419Fungal corneal ulcer complicated by endophthalmitis: clinical and laboratory diagnostics, treatment tacticsL. A. Kovaleva0G. I. Krichevskaya1P. V. Maкarov2A. O. Petrova3S. V. Flora4I. D. Zyurnyayeva5A. E. Andryushi6O. I. Markelova7Helmholtz National Medical Research Center of Eye DiseasesHelmholtz National Medical Research Center of Eye DiseasesHelmholtz National Medical Research Center of Eye DiseasesHelmholtz National Medical Research Center of Eye DiseasesHelmholtz National Medical Research Center of Eye DiseasesHelmholtz National Medical Research Center of Eye DiseasesHelmholtz National Medical Research Center of Eye DiseasesHelmholtz National Medical Research Center of Eye DiseasesPurpose: to study the clinical signs and effectiveness of laboratory diagnostics of fungal corneal ulcer complicated by endophthalmitis aimed at treatment tactics optimization.Materials and methods. 15 patients aged 20–55 with severe monocular fungal ulcer complicated by endophthalmitis were examined by microscopy and culture of corneal scraping on Sabouraud Agar; microscopy and culture of intraocular fluid and corneal fragments, obtained during the surgical treatment. Corneal scrapings from the corneal ulcer and corneal fragments removed during keratoplasty were tested in polymerase chain reaction (PCR) for the presence of deoxyribonucleic acid (DNA) of Candida albicans and total Fungi DNA.Results. Before treatment start, 2.5 hours after the biomaterial was taken, PCR revealed Fungi DNA in all 15 cases. Symptoms of the severe fungal corneal ulcer complicated by endophthalmitis and caused by Aspergillus spp have been identified and described. Conservative therapy and total penetrating keratoplasty (PKP) helped retain the eye in 13 out of 15 patients (86.7 %) and partially restore the visual functions.Conclusion. Rapid laboratory diagnosis of ophthalmomycosis using PCR offers an advantage over the culturing technique: the results are ready within 2.5 hours instead of 10-14 days (culture method); it is highly sensitive and allows identifying the fungi not only in the tissue of the removed cornea, but also in the сorneal scrapings. The effective treatment tactics of fungal corneal ulcer complicated by endophthalmitis combining PKP with pre-operative and long-term postoperative antifungal therapy was proposed.https://roj.igb.ru/jour/article/view/882fungal corneal ulcersfungal endophthalmitislaboratory diagnosticspcr |
| spellingShingle | L. A. Kovaleva G. I. Krichevskaya P. V. Maкarov A. O. Petrova S. V. Flora I. D. Zyurnyayeva A. E. Andryushi O. I. Markelova Fungal corneal ulcer complicated by endophthalmitis: clinical and laboratory diagnostics, treatment tactics Российский офтальмологический журнал fungal corneal ulcers fungal endophthalmitis laboratory diagnostics pcr |
| title | Fungal corneal ulcer complicated by endophthalmitis: clinical and laboratory diagnostics, treatment tactics |
| title_full | Fungal corneal ulcer complicated by endophthalmitis: clinical and laboratory diagnostics, treatment tactics |
| title_fullStr | Fungal corneal ulcer complicated by endophthalmitis: clinical and laboratory diagnostics, treatment tactics |
| title_full_unstemmed | Fungal corneal ulcer complicated by endophthalmitis: clinical and laboratory diagnostics, treatment tactics |
| title_short | Fungal corneal ulcer complicated by endophthalmitis: clinical and laboratory diagnostics, treatment tactics |
| title_sort | fungal corneal ulcer complicated by endophthalmitis clinical and laboratory diagnostics treatment tactics |
| topic | fungal corneal ulcers fungal endophthalmitis laboratory diagnostics pcr |
| url | https://roj.igb.ru/jour/article/view/882 |
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