Skip to main content
SpringerLink
Log in
Book cover

Aspergillosis: From Diagnosis to Prevention pp 973–998Cite as

Aspergillus Keratitis

  • Chapter
  • First Online:

Abstract

The cornea must be perfectly transparent to allow an individual to visualize his/her environment. Keratitis, an inflammation of the cornea that frequently arises due to infection, is a threat to corneal transparency. Species of Aspergillus may cause keratitis, especially in outdoor workers in agricultural communities in the developing world and in tropical and subtropical areas. Aspergillus keratitis frequently occurs following traumatic inoculation of Aspergillus conidia into the cornea through injury or surgical procedures, but other factors may also predispose to the infection. Aspergillus keratitis is a medical emergency, since the patient frequently presents with extreme pain and loss of vision, and needs to be recognized and treated promptly. A presumptive diagnosis of Aspergillus keratitis can be established by a careful clinical examination and by direct microscopic examination of stained smears of corneal scrape material. The diagnosis can be confirmed by culture. Other, more rapid methods of diagnosis such as confocal microscopy and molecular methods have also been described. For therapy, topical application of natamycin (5%) or amphotericin B (0.15%) drops is most widely used. Intracameral injection of amphotericin B is a recently described alternative to topical use. Itraconazole, as an oral preparation or ophthalmic solution, has also been successfully used. Recently, voriconazole, administered by different routes, has shown considerable promise for therapy. Surgical intervention includes debridement, lamellar keratectomy/keratoplasty, or a conjunctival flap and may be required in patients with deep lesions. Therapeutic penetrating keratoplasty may be the final resort for uncontrolled infection. A better understanding of the pathogenesis of Aspergillus keratitis may improve its outcome.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   259.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   329.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Whitcher, J. P. & Srinivasan, M. (1997) Corneal ulceration in the developing world – a silent epidemic. Br J Ophthalmol, 81, 622–3.

    Article  CAS  PubMed  Google Scholar 

  2. Srinivasan, M., Gonzales, C. A., George, C., Cevallos, V., Mascarenhas, J. M., Asokan, B., Wilkins, J., Smolin, G. & Whitcher, J. P. (1997) Epidemiology and aetiological diagnosis of corneal ulceration in Madurai, South India. Br J Ophthalmol, 81, 965–71.

    Article  CAS  PubMed  Google Scholar 

  3. Tanure, M. A., Cohen, E. J., Sudesh, S., Rapuano, C. J. & Laibson, P. R. (2000) Spectrum of fungal keratitis at Wills Eye Hospital, Philadelphia, Pennsylvania. Cornea, 19, 307–12.

    Article  CAS  PubMed  Google Scholar 

  4. Sun, X. G., Zhang, Y., Li, R., Wang, Z. Q., Luo, S. Y., Jin, X. Y. & Zhang, W. H. (2004) Etiological analysis on ocular fungal infection in the period of 1989–2000. Chin Med J (Engl), 117, 598–600.

    Google Scholar 

  5. Hofling-Lima, A. L., Forseto, A., Duprat, J. P., Andrade, A., Souza, L. B., Godoy, P. & Freitas, D. (2005) [Laboratory study of the mycotic infectious eye diseases and factors associated with keratitis]. Arq Bras Oftalmol, 68, 21–7.

    PubMed  Google Scholar 

  6. Boonpasart, S., Kasetsuwan, N., Puangsricharern, V., Pariyakanok, L. & Jittpoonkusol, T. (2002) Infectious keratitis at King Chulalongkorn Memorial Hospital: a 12-year retrospective study of 391 cases. J Med Assoc Thai, 85 Suppl 1, S217–30.

    PubMed  Google Scholar 

  7. Norina, T. J., Raihan, S., Bakiah, S., Ezanee, M., Liza-Sharmini, A. T. & Wan Hazzabah, W. H. (2008) Microbial keratitis: aetiological diagnosis and clinical features in patients admitted to Hospital Universiti Sains Malaysia. Singapore Med J, 49, 67–71.

    CAS  PubMed  Google Scholar 

  8. Basak, S. K., Basak, S., Mohanta, A. & Bhowmick, A. (2005) Epidemiological and microbiological diagnosis of suppurative keratitis in Gangetic West Bengal, Eastern India. Indian J Ophthalmol, 53, 17–22.

    Article  PubMed  Google Scholar 

  9. Khanal, B., Deb, M., Panda, A. & Sethi, H. S. (2005) Laboratory diagnosis in ulcerative keratitis. Ophthalmic Res, 37, 123–7.

    Article  CAS  PubMed  Google Scholar 

  10. Leck, A. K., Thomas, P. A., Hagan, M., Kaliamurthy, J., Ackuaku, E., John, M., Newman, M. J., Codjoe, F. S., Opintan, J. A., Kalavathy, C. M., Essuman, V., Jesudasan, C. A. & Johnson, G. J. (2002) Aetiology of suppurative corneal ulcers in Ghana and South India, and epidemiology of fungal keratitis. Br J Ophthalmol, 86, 1211–5.

    Article  CAS  PubMed  Google Scholar 

  11. Galarreta, D. J., Tuft, S. J., Ramsay, A. & Dart, J. K. (2007) Fungal keratitis in London: microbiological and clinical evaluation. Cornea, 26, 1082–6.

    Article  PubMed  Google Scholar 

  12. Houang, E., Lam, D., Fan, D. & Seal, D. (2001) Microbial keratitis in Hong Kong: relationship to climate, environment and contact-lens disinfection. Trans R Soc Trop Med Hyg, 95, 361–7.

    Article  CAS  PubMed  Google Scholar 

  13. Bharathi, M. J., Ramakrishnan, R., Vasu, S., Meenakshi, R. & Palaniappan, R. (2003) Epidemiological characteristics and laboratory diagnosis of fungal keratitis. A three-year study. Indian J Ophthalmol, 51, 315–21.

    PubMed  Google Scholar 

  14. Rondeau, N., Bourcier, T., Chaumeil, C., Borderie, V., Touzeau, O., Scat, Y., Thomas, F., Baudouin, C., Nordmann, J. P. & Laroche, L. (2002) [Fungal keratitis at the Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts: retrospective study of 19 cases]. J Fr Ophtalmol, 25, 890–6.

    CAS  PubMed  Google Scholar 

  15. Sharma, S., Gopalakrishnan, S., Aasuri, M. K., Garg, P. & Rao, G. N. (2003) Trends in contact lens-associated microbial keratitis in Southern India. Ophthalmology, 110, 138–43.

    Article  PubMed  Google Scholar 

  16. Chowdhary, A. & Singh, K. (2005) Spectrum of fungal keratitis in North India. Cornea, 24, 8–15.

    Article  PubMed  Google Scholar 

  17. Thomas, P. A. (2003) Current perspectives on ophthalmic mycoses. Clin Microbiol Rev, 16, 730–97.

    Article  CAS  PubMed  Google Scholar 

  18. Mancini, N., Perotti, M., Ossi, C. M., Cavallero, A., Matuska, S., Paganoni, G., Burioni, R., Rama, P. & Clementi, M. (2006) Rapid molecular identification of fungal pathogens in corneal samples from suspected keratomycosis cases. J Med Microbiol, 55, 1505–9.

    Article  CAS  PubMed  Google Scholar 

  19. Kumar, M. & Shukla, P. K. (2005) Use of PCR targeting of internal transcribed spacer regions and single-stranded conformation polymorphism analysis of sequence variation in different regions of rrna genes in fungi for rapid diagnosis of mycotic keratitis. J Clin Microbiol, 43, 662–8.

    Article  CAS  PubMed  Google Scholar 

  20. Thomas, P. A. & Geraldine, P. (2007) Infectious keratitis. Curr Opin Infect Dis, 20, 129–41.

    Article  PubMed  Google Scholar 

  21. Gingrich, W. D. (1962) Keratomycosis. JAMA, 179, 602–8.

    CAS  PubMed  Google Scholar 

  22. Kumari, N., Xess, A. & Shahi, S. K. (2002) A study of keratomycosis: our experience. Indian J Pathol Microbiol, 45, 299–302.

    PubMed  Google Scholar 

  23. Bashir, G., Shah, A., Thokar, M. A., Rashid, S. & Shakeel, S. (2005) Bacterial and fungal profile of corneal ulcers – a prospective study. Indian J Pathol Microbiol, 48, 273–7.

    PubMed  Google Scholar 

  24. Saha, R. & Das, S. (2006) Mycological profile of infectious Keratitis from Delhi. Indian J Med Res, 123, 159–64.

    PubMed  Google Scholar 

  25. Bhartiya, P., Daniell, M., Constantinou, M., Islam, F. M. & Taylor, H. R. (2007) Fungal keratitis in Melbourne. Clin Exp Ophthalmol, 35, 124–30.

    Google Scholar 

  26. Alvarez-De-Carvalho, A. C., Iran-Ruthes, H., Maia, M., Yana, D., Teruo-Sato, M., Moreira, H., Fernandes-Bordignon, G. & De-Queiroz-Telles, F. (2001) [Fungal keratitis in the State of Parana-Brazil: clinical, epidemiological and diagnostic findings]. Rev Iberoam Micol, 18, 76–8.

    CAS  PubMed  Google Scholar 

  27. Maidana, E., Gonzalez, R., Melo Junior, L. A. & Souza, L. B. (2005) [Infectious keratitis in children: an epidemiological and microbiological study in a university hospital in Asuncion-Paraguay.]. Arq Bras Oftalmol, 68, 828–32.

    Article  PubMed  Google Scholar 

  28. Iyer, S. A., Tuli, S. S. & Wagoner, R. C. (2006) Fungal keratitis: emerging trends and treatment outcomes. Eye Contact Lens, 32, 267–71.

    Article  PubMed  Google Scholar 

  29. Khairallah, S. H., Byrne, K. A. & Tabbara, K. F. (1992) Fungal keratitis in Saudi Arabia. Doc Ophthalmol, 79, 269–76.

    Article  CAS  PubMed  Google Scholar 

  30. Chang, C. W., Ho, C. K., Chen, Z. C., Hwang, Y. H., Chang, C. Y., Liu, S. T., Chen, M. J. & Chen, M. Y. (2002) Fungi genus and concentration in the air of onion fields and their opportunistic action related to mycotic keratitis. Arch Environ Health, 57, 349–54.

    Article  PubMed  Google Scholar 

  31. Mendicute, J., Orbegozo, J., Ruiz, M., Saiz, A., Eder, F. & Aramberri, J. (2000) Keratomycosis after cataract surgery. J Cataract Refract Surg, 26, 1660–6.

    Article  CAS  PubMed  Google Scholar 

  32. Sridhar, M. S., Garg, P., Bansal, A. K. & Gopinathan, U. (2000) Aspergillus flavus keratitis after laser in situ keratomileusis. Am J Ophthalmol, 129, 802–4.

    Article  CAS  PubMed  Google Scholar 

  33. Sridhar, M. S., Gopinathan, U. & Rao, G. N. (2003) Fungal keratitis associated with vernal keratoconjunctivitis. Cornea, 22, 80–1.

    Article  CAS  PubMed  Google Scholar 

  34. Kaushik, S., Ram, J., Brar, G. S., Jain, A. K., Chakraborti, A. & Gupta, A. (2001) Intracameral amphotericin B: initial experience in severe keratomycosis. Cornea, 20, 715–9.

    Article  CAS  PubMed  Google Scholar 

  35. Garg, P., Mahesh, S., Bansal, A. K., Gopinathan, U. & Rao, G. N. (2003) Fungal infection of sutureless self-sealing incision for cataract surgery. Ophthalmology, 110, 2173–7.

    Article  PubMed  Google Scholar 

  36. Freda, R. (2006) Use of oral voriconazole as adjunctive treatment of severe cornea fungal infection: case report. Arq Bras Oftalmol, 69, 431–4.

    Article  PubMed  Google Scholar 

  37. Jain, V., Maiti, A., Shome, D., Borse, N. & Natarajan, S. (2007) Aspergillus-induced malignant glaucoma. Cornea, 26, 762–3.

    Article  PubMed  Google Scholar 

  38. Sun, Y., Jain, A. & Ta, C. N. (2007) Aspergillus fumigatus keratitis following laser in situ keratomileusis. J Cataract Refract Surg, 33, 1806–7.

    Article  PubMed  Google Scholar 

  39. Sridhar, M. S., Gopinathan, U., Garg, P. & Rao, G. N. (2001) Aspergillus fumigatus keratitis with wreath pattern infiltrates. Cornea, 20, 534–5.

    Article  CAS  PubMed  Google Scholar 

  40. Kuo, I. C., Margolis, T. P., Cevallos, V. & Hwang, D. G. (2001) Aspergillus fumigatus keratitis after laser in situ keratomileusis. Cornea, 20, 342–4.

    Article  CAS  PubMed  Google Scholar 

  41. Cho, B. J., Lee, G. J., Ha, S. Y., Seo, Y. H. & Tchah, H. (2002) Co-infection of the human Cornea with Stenotrophomonas maltophilia and Aspergillus fumigatus. Cornea, 21, 628–31.

    Article  PubMed  Google Scholar 

  42. Ritterband, D., Kelly, J., Mcnamara, T., Kresloff, M., Koplin, R. & Seedor, J. (2002) Delayed-onset multifocal polymicrobial keratitis after laser in situ keratomileusis. J Cataract Refract Surg, 28, 898–9.

    Article  PubMed  Google Scholar 

  43. Fahad, B., Mckellar, M., Armstrong, M., Denning, D. & Tullo, A. (2004) Aspergillus keratitis following corneal foreign body. Br J Ophthalmol, 88, 847–8.

    Article  CAS  PubMed  Google Scholar 

  44. Shokohi, T., Nowroozpoor-Dailami, K. & Moaddel-Haghighi, T. (2006) Fungal keratitis in patients with corneal ulcer in Sari, Northern Iran. Arch Iran Med, 9, 222–7.

    PubMed  Google Scholar 

  45. Rahimi, F., Hashemian, M. N. & Rajabi, M. T. (2007) Aspergillus fumigatus keratitis after laser in situ keratomileusis: a case report and review of post-LASIK fungal keratitis. Eye, 21, 843–5.

    Article  CAS  PubMed  Google Scholar 

  46. Stewart, R. M., Quah, S. A., Neal, T. J. & Kaye, S. B. (2007) The use of voriconazole in the treatment of Aspergillus fumigatus keratitis. Br J Ophthalmol, 91, 1094–6.

    PubMed  Google Scholar 

  47. Thiel, M. A., Zinkernagel, A. S., Burhenne, J., Kaufmann, C. & Haefeli, W. E. (2007) Voriconazole concentration in human aqueous humor and plasma during topical or combined topical and systemic administration for fungal keratitis. Antimicrob Agents Chemother, 51, 239–44.

    Article  CAS  PubMed  Google Scholar 

  48. Iaccheri, B., Roque, M., Fiore, T., Papadaki, T., Mathew, B., Baltatzis, S., Emara, B., Tokarewicz, A. C. & Foster, C. S. (2004) Ocular cicatricial pemphigoid, keratomycosis, and intravenous immunoglobulin therapy. Cornea, 23, 819–22.

    Article  PubMed  Google Scholar 

  49. Kredics, L., Varga, J., Kocsube, S., Doczi, I., Samson, R. A., Rajaraman, R., Narendran, V., Bhaskar, M., Vagvolgyi, C. & Manikandan, P. (2007) Case of keratitis caused by Aspergillus tamarii. J Clin Microbiol, 45, 3464–7.

    Article  PubMed  Google Scholar 

  50. Sridhar, M. S., Sharma, S., Gopinathan, U. & Rao, G. N. (2002) Anterior chamber tap: diagnostic and therapeutic indications in the management of ocular infections. Cornea, 21, 718–22.

    Article  CAS  PubMed  Google Scholar 

  51. Tamcelik, N., Ozdamar, A., Kizilkaya, M., Devranoglu, K., Ustundag, C. & Demirkesen, C. (2002) Fungal keratitis after nonpenetrating glaucoma surgery. Cornea, 21, 532–4.

    Article  PubMed  Google Scholar 

  52. Das, S., Ramamurthy, B. & Sangwan, V. S. (2009) Fungal keratitis following amniotic membrane transplantation. Int Ophthalmol, 29, 49–51.

    Article  PubMed  Google Scholar 

  53. Dunlop, A. A., Wright, E. D., Howlader, S. A., Nazrul, I., Husain, R., Mcclellan, K. & Billson, F. A. (1994) Suppurative corneal ulceration in Bangladesh. A study of 142 cases examining the microbiological diagnosis, clinical and epidemiological features of bacterial and fungal keratitis. Aust N Z J Ophthalmol, 22, 105–10.

    Article  CAS  PubMed  Google Scholar 

  54. Wong, T. Y., Ng, T. P., Fong, K. S. & Tan, D. T. (1997) Risk factors and clinical outcomes between fungal and bacterial keratitis: a comparative study. CLAO J, 23, 275–81.

    CAS  PubMed  Google Scholar 

  55. Gopinathan, U., Garg, P., Fernandes, M., Sharma, S., Athmanathan, S. & Rao, G. N. (2002) The epidemiological features and laboratory results of fungal keratitis: a 10-year review at a referral eye care center in South India. Cornea, 21, 555–9.

    Article  PubMed  Google Scholar 

  56. Xie, L., Dong, X. & Shi, W. (2001) Treatment of fungal keratitis by penetrating keratoplasty. Br J Ophthalmol, 85, 1070–4.

    Article  CAS  PubMed  Google Scholar 

  57. Lin, S. H., Lin, C. P., Wang, H. Z., Tsai, R. K. & Ho, C. K. (1999) Fungal corneal ulcers of onion harvesters in Southern Taiwan. Occup Environ Med, 56, 423–5.

    Article  CAS  PubMed  Google Scholar 

  58. Thomas, P. A. (1990) Fungi in keratitis: detection, susceptibility patterns and pathogenic mechanisms. Tiruchirapalli, India, Bharathidasan University.

    Google Scholar 

  59. Cuero, R. G. (1980) Ecological distribution of Fusarium solani and its opportunistic action related to mycotic keratitis in Cali, Colombia. J Clin Microbiol, 12, 455–61.

    CAS  PubMed  Google Scholar 

  60. Wilhelmus, K. R. (2005) Climatology of dematiaceous fungal keratitis. Am J Ophthalmol, 140, 1156–7.

    Article  PubMed  Google Scholar 

  61. Weichel, E. D., Bower, K. S., Ward, T. P. & Hidayat, A. (2002) EpiCorneal aspergilloma after penetrating keratoplasty. Cornea, 21, 825–7.

    Article  CAS  PubMed  Google Scholar 

  62. Burt, B., Pappas, G. & Simcock, P. (2003) Hospital acquired Aspergillus keratitis. Br J Ophthalmol, 87, 923.

    Article  CAS  PubMed  Google Scholar 

  63. Rosa, R. H., Jr., Miller, D. & Alfonso, E. C. (1994) The changing spectrum of fungal keratitis in South Florida. Ophthalmology, 101, 1005–13.

    PubMed  Google Scholar 

  64. Jones, B. R. (1975) Principles in the management of oculomycosis. XXXI Edward Jackson memorial lecture. Am J Ophthalmol, 79, 719–51.

    CAS  PubMed  Google Scholar 

  65. Vemuganti, G. K., Garg, P., Gopinathan, U., Naduvilath, T. J., John, R. K., Buddi, R. & Rao, G. N. (2002) Evaluation of agent and host factors in progression of mycotic keratitis: A histologic and microbiologic study of 167 corneal buttons. Ophthalmology, 109, 1538–46.

    Article  PubMed  Google Scholar 

  66. Avunduk, A. M., Beuerman, R. W., Varnell, E. D. & Kaufman, H. E. (2003) Confocal microscopy of Aspergillus fumigatus keratitis. Br J Ophthalmol, 87, 409–10.

    Article  CAS  PubMed  Google Scholar 

  67. Winchester, K., Mathers, W. D. & Sutphin, J. E. (1997) Diagnosis of Aspergillus keratitis in vivo with confocal microscopy. Cornea, 16, 27–31.

    Article  CAS  PubMed  Google Scholar 

  68. Brasnu, E., Bourcier, T., Dupas, B., Degorge, S., Rodallec, T., Laroche, L., Borderie, V. & Baudouin, C. (2007) In vivo confocal microscopy in fungal keratitis. Br J Ophthalmol, 91, 588–91.

    Article  PubMed  Google Scholar 

  69. Agrawal, V., Biswas, J., Madhavan, H. N., Mangat, G., Reddy, M. K., Saini, J. S., Sharma, S. & Srinivasan, M. (1994) Current perspectives in infectious keratitis. Indian J Ophthalmol, 42, 171–92.

    CAS  PubMed  Google Scholar 

  70. Jacob, P., Gopinathan, U., Sharma, S. & Rao, G. N. (1995) Calcium alginate swab versus Bard Parker blade in the diagnosis of microbial keratitis. Cornea, 14, 360–4.

    Article  CAS  PubMed  Google Scholar 

  71. Ishibashi, Y., Hommura, S. & Matsumoto, Y. (1987) Direct examination vs culture of biopsy specimens for the diagnosis of keratomycosis. Am J Ophthalmol, 103, 636–40.

    CAS  PubMed  Google Scholar 

  72. Kompa, S., Langefeld, S., Kirchhof, B. & Schrage, N. (1999) Corneal biopsy in keratitis performed with the microtrephine. Graefes Arch Clin Exp Ophthalmol, 237, 915–9.

    Article  CAS  PubMed  Google Scholar 

  73. Mcguire, T. W., Bullock, J. D., Bullock, J. D., Jr., Elder, B. L. & Funkhouser, J. W. (1991) Fungal endophthalmitis. An experimental study with a review of 17 human ocular cases. Arch Ophthalmol, 109, 1289–96.

    CAS  PubMed  Google Scholar 

  74. Arffa, R. C., Avni, I., Ishibashi, Y., Robin, J. & Kaufman, H. E. (1985) Calcofluor and ink-potassium hydroxide preparations for identifying fungi. Am J Ophthalmol, 100, 719–23.

    CAS  PubMed  Google Scholar 

  75. Thomas, P. A., Kaliamurthy, J., Jesudasan, C. A. & Geraldine, P. (2008) Use of chlorazol black E mounts of corneal scrapes for diagnosis of filamentous fungal keratitis. Am J Ophthalmol, 145, 971–6.

    Article  CAS  PubMed  Google Scholar 

  76. Thomas, P. A., Kuriakose, T., Kirupashanker, M. P. & Maharajan, V. S. (1991) Use of lactophenol cotton blue mounts of corneal scrapings as an aid to the diagnosis of mycotic keratitis. Diagn Microbiol Infect Dis, 14, 219–24.

    Article  CAS  PubMed  Google Scholar 

  77. Robin, J. B., Chan, R., Rao, N. A., Sharma, S. & Srinivasan, M. (1989) Fluorescein-conjugated lectin visualization of fungi and acanthamoebae in infectious keratitis. Ophthalmology, 96, 1198–202.

    CAS  PubMed  Google Scholar 

  78. Garcia, M. E., Blanco, J. L., Caballero, J. & Gargallo-Viola, D. (2002) Anticoagulants interfere with PCR used to diagnose invasive aspergillosis. J Clin Microbiol, 40, 1567–8.

    Article  CAS  PubMed  Google Scholar 

  79. Ferrer, C., Colom, F., Frases, S., Mulet, E., Abad, J. L. & Alio, J. L. (2001) Detection and identification of fungal pathogens by PCR and by ITS2 and 5.8S ribosomal DNA typing in ocular infections. J Clin Microbiol, 39, 2873–9.

    Article  CAS  PubMed  Google Scholar 

  80. Gaudio, P. A., Gopinathan, U., Sangwan, V. & Hughes, T. E. (2002) Polymerase chain reaction based detection of fungi in infected corneas. Br J Ophthalmol, 86, 755–60.

    Article  CAS  PubMed  Google Scholar 

  81. Qiu, W. Y., Yao, Y. F., Zhu, Y. F., Zhang, Y. M., Zhou, P., Jin, Y. Q. & Zhang, B. (2005) Fungal spectrum identified by a new slide culture and in vitro drug susceptibility using Etest in fungal keratitis. Curr Eye Res, 30, 1113–20.

    Article  CAS  PubMed  Google Scholar 

  82. Lalitha, P., Shapiro, B. L., Srinivasan, M., Prajna, N. V., Acharya, N. R., Fothergill, A. W., Ruiz, J., Chidambaram, J. D., Maxey, K. J., Hong, K. C., Mcleod, S. D. & Lietman, T. M. (2007) Antimicrobial susceptibility of Fusarium, Aspergillus, and other filamentous fungi isolated from keratitis. Arch Ophthalmol, 125, 789–93.

    Article  CAS  PubMed  Google Scholar 

  83. Dong, X., Shi, W., Zeng, Q. & Xie, L. (2005) Roles of adherence and matrix metalloproteinases in growth patterns of fungal pathogens in cornea. Curr Eye Res, 30, 613–20.

    Article  CAS  PubMed  Google Scholar 

  84. Zhao, J. & Wu, X. Y. (2008) Triggering of toll-like receptors 2 and 4 by Aspergillus fumigatus conidia in immortalized human corneal epithelial cells to induce inflammatory cytokines. Chin Med J (Engl), 121, 450–4.

    CAS  Google Scholar 

  85. Xie, L., Zhai, H., Shi, W., Zhao, J., Sun, S. & Zang, X. (2008) Hyphal growth patterns and recurrence of fungal keratitis after lamellar keratoplasty. Ophthalmology, 115, 983–7.

    Article  PubMed  Google Scholar 

  86. Kuriakose, T. & Thomas, P. A. (1991) Keratomycotic malignant glaucoma. Indian J Ophthalmol, 39, 118–21.

    CAS  PubMed  Google Scholar 

  87. Gopinathan, U., Ramakrishna, T., Willcox, M., Rao, C. M., Balasubramanian, D., Kulkarni, A., Vemuganti, G. K. & Rao, G. N. (2001) Enzymatic, clinical and histologic evaluation of corneal tissues in experimental fungal keratitis in rabbits. Exp Eye Res, 72, 433–42.

    Article  CAS  PubMed  Google Scholar 

  88. Zhu, W. S., Wojdyla, K., Donlon, K., Thomas, P. A. & Eberle, H. I. (1990) Extracellular proteases of Aspergillus flavus. Fungal keratitis, proteases, and pathogenesis. Diagn Microbiol Infect Dis, 13, 491–7.

    Article  CAS  PubMed  Google Scholar 

  89. Biswas, N. R., Das, H., Satpathy, G., Mohanty, S. & Panda, A. (2001) Role of aprotinin in the management of experimental fungal keratitis. Ophthalmic Res, 33, 147–50.

    Article  CAS  PubMed  Google Scholar 

  90. Wang, Y., Liu, T., Gong, H., Zhou, Q., Sun, S. & Xie, L. (2007) Gene profiling in murine corneas challenged with Aspergillus fumigatus. Mol Vis, 13, 1226–33.

    CAS  PubMed  Google Scholar 

  91. Komadina, T. G., Wilkes, T. D., Shock, J. P., Ulmer, W. C., Jackson, J. & Bradsher, R. W. (1985) Treatment of Aspergillus fumigatus keratitis in rabbits with oral and topical ketoconazole. Am J Ophthalmol, 99, 476–9.

    CAS  PubMed  Google Scholar 

  92. Van Cutsem, J. & Van Gerven, F. (1991) Antifungal in-vitro activity of itraconazole. J Myco Med, 1, 10–5.

    Google Scholar 

  93. Avunduk, A. M., Beuerman, R. W., Warnel, E. D., Kaufman, H. E. & Greer, D. (2003) Comparison of efficacy of topical and oral fluconazole treatment in experimental Aspergillus keratitis. Curr Eye Res, 26, 113–7.

    Article  PubMed  Google Scholar 

  94. Panda, A., Ahuja, R., Biswas, N. R., Satpathy, G. & Khokhar, S. (2003) Role of 0.02% polyhexamethylene biguanide and 1% povidone iodine in experimental Aspergillus keratitis. Cornea, 22, 138–41.

    Article  PubMed  Google Scholar 

  95. Morand, K., Bartoletti, A. C., Bochot, A., Barratt, G., Brandely, M. L. & Chast, F. (2007) Liposomal amphotericin B eye drops to treat fungal keratitis: physico-chemical and formulation stability. Int J Pharm, 344, 150–3.

    Article  CAS  PubMed  Google Scholar 

  96. Thomas, P. A. & Rajasekaran, J. (1988) Treatment of Aspergillus keratitis with imidazoles and related compounds. In Vanden Bossche, H., Mackenzie, D. W. R. & Cauwenbergh, G. (Eds.) Aspergillus and Aspergillosis. New York, USA, Plenum Press.

    Google Scholar 

  97. Hirose, H., Terasaki, H., Awaya, S. & Yasuma, T. (1997) Treatment of fungal corneal ulcers with amphotericin B ointment. Am J Ophthalmol, 124, 836–8.

    CAS  PubMed  Google Scholar 

  98. Mendicute, J., Ondarra, A., Eder, F., Ostolaza, J. I., Salaberria, M. & Lamsfus, J. M. (1995) The use of collagen shields impregnated with amphotericin B to treat Aspergillus keratomycosis. CLAO J, 21, 252–5.

    CAS  PubMed  Google Scholar 

  99. Yilmaz, S., Ture, M. & Maden, A. (2007) Efficacy of intracameral amphotericin B injection in the management of refractory keratomycosis and endophthalmitis. Cornea, 26, 398–402.

    Article  PubMed  Google Scholar 

  100. Kalavathy, C. M., Parmar, P., Kaliamurthy, J., Philip, V. R., Ramalingam, M. D., Jesudasan, C. A. & Thomas, P. A. (2005) Comparison of topical itraconazole 1% with topical natamycin 5% for the treatment of filamentous fungal keratitis. Cornea, 24, 449–52.

    Article  CAS  PubMed  Google Scholar 

  101. Ishibashi, Y., Matsumoto, Y. & Takei, K. (1984) The effects of intravenous miconazole on fungal keratitis. Am J Ophthalmol, 98, 433–7.

    Article  CAS  PubMed  Google Scholar 

  102. Foster, C. S. (1981) Miconazole therapy for keratomycosis. Am J Ophthalmol, 91, 622–9.

    CAS  PubMed  Google Scholar 

  103. Searl, S. S., Udell, I. J., Sadun, A., Hyslop, N. E., Jr., Albert, D. M. & Kenyon, K. R. (1981) Aspergillus keratitis with intraocular invasion. Ophthalmology, 88, 1244–50.

    CAS  PubMed  Google Scholar 

  104. Torres, M. A., Mohamed, J., Cavazos-Adame, H. & Martinez, L. A. (1985) Topical ketoconazole for fungal keratitis. Am J Ophthalmol, 100, 293–8.

    CAS  PubMed  Google Scholar 

  105. Thomas, P. A., Kalavathy, C. M., Abraham, D. J. & Rajasekaran, J. (1987) Oral ketoconazole in Keratomycosis. Indian J Ophthalmol, 35, 197–203.

    CAS  PubMed  Google Scholar 

  106. Rajasekaran, J., Thomas, P. A. & Srinivasan, R. (1987) Ketoconazole in keratomycosis. In Blodi, F., Brancato, R. & Cristini, G. (Eds.) Acta XXV Concilium Ophthalmologicum. Amsterdam, The Netherlands, Kugler Ghedini.

    Google Scholar 

  107. Coriglione, G., Stella, G., Gafa, L., Spata, G., Oliveri, S., Padhye, A. A. & Ajello, L. (1990) Neosartorya fischeri var fischeri (Wehmer) Malloch and Cain 1972 (anamorph: Aspergillus fischerianus Samson and Gams 1985) as a cause of mycotic keratitis. Eur J Epidemiol, 6, 382–5.

    Article  CAS  PubMed  Google Scholar 

  108. Thomas, P. A., Abraham, D. J., Kalavathy, C. M. & Rajasekaran, J. (1988) Oral itraconazole therapy for mycotic keratitis. Mycoses, 31, 271–9.

    Article  CAS  PubMed  Google Scholar 

  109. Rajasekaran, J., Thomas, P. A., Kalavathy, C. M., Joseph, P. C. & Abraham, D. J. (1987) Itraconazole therapy for fungal keratitis. Indian J Ophthalmol, 35, 157–60.

    CAS  PubMed  Google Scholar 

  110. Mehta, H., Mehta, H. B., Garg, P. & Kodial, H. (2008) Voriconazole for the treatment of refractory Aspergillus fumigatus keratitis. Indian J Ophthalmol, 56, 243–5.

    Article  PubMed  Google Scholar 

  111. Hariprasad, S. M., Mieler, W. F., Holz, E. R., Gao, H., Kim, J. E., Chi, J. & Prince, R. A. (2004) Determination of vitreous, aqueous, and plasma concentration of orally administered voriconazole in humans. Arch Ophthalmol, 122, 42–7.

    Article  CAS  PubMed  Google Scholar 

  112. Lalitha, P., Prajna, N. V., Kabra, A., Mahadevan, K. & Srinivasan, M. (2006) Risk factors for treatment outcome in fungal keratitis. Ophthalmology, 113, 526–30.

    Article  PubMed  Google Scholar 

  113. Xie, L., Hu, J. & Shi, W. (2008) Treatment failure after lamellar keratoplasty for fungal keratitis. Ophthalmology, 115, 33–6.

    Article  PubMed  Google Scholar 

  114. Lin, C. P., Chang, C. W. & Su, C. Y. (2005) Phototherapeutic keratectomy in treating keratomycosis. Cornea, 24, 262–8.

    Article  PubMed  Google Scholar 

  115. Xie, L., Shi, W., Liu, Z. & Li, S. (2002) Lamellar keratoplasty for the treatment of fungal keratitis. Cornea, 21, 33–7.

    Article  PubMed  Google Scholar 

  116. Kim, J. S., Kim, J. C., Hahn, T. W. & Park, W. C. (2001) Amniotic membrane transplantation in infectious Corneal ulcer. Cornea, 20, 720–6.

    Article  CAS  PubMed  Google Scholar 

  117. Chen, H. C., Tan, H. Y., Hsiao, C. H., Huang, S. C., Lin, K. K. & Ma, D. H. (2006) Amniotic membrane transplantation for persistent Corneal ulcers and perforations in acute fungal keratitis. Cornea, 25, 564–72.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Microbiology, Institute of Ophthalmology, Joseph Eye Hospital, P.B. 138, 620001, Tiruchirapalli, India

    Philip A. Thomas

Authors
  1. Philip A. Thomas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Philip A. Thomas .

Editor information

Editors and Affiliations

  1. Porto Alegre, Complexo Hospitalar Santa Casa de, Av. Independencia 155, Porto Alegre, 90035-075, Brazil

    Alessandro Comarú Pasqualotto

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer Science+Business Media B.V.

About this chapter

Cite this chapter

Thomas, P.A. (2009). Aspergillus Keratitis. In: Comarú Pasqualotto, A. (eds) Aspergillosis: From Diagnosis to Prevention. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-2408-4_57

Download citation

Publish with us

Policies and ethics

Search

Navigation