The Correlation Analysis Between Genera And The Prognosis In Fungal Keratitis

ObjectiveTo study the the relationship between different genera and the disease prognosisin fungal keratitis by observing the clinical features, the end of the disease, thetreatment cycle and the best corrected visual acuity of the patients cured bymedicines.MethodsRetrospective series case study.466cases of fungal keratits from March2012toFebruary2013in Henan Eye Institute were collected. Slit-lamp examination,corneal smears examination, confocal microscopy, fungal culture and strainsidentification were used to diagnose. Follow up the treatment outcomes and recordthe best corrected visual acuity and the period of treatment of the patients cured bymedicines. χ2test, rank sum test and one-way analysis of variance were used toanalyze data.ResultsDuring this466cases of fungal keratits,237cases infected by fusaria (50.9%),94cases infected by alternaria (20.2%),68cases infected by aspergilli (14.6%), and67cases infected by other genera (14.4%). During the324cases which were electedto participate in this study, the surgery rate of the fungal keratitis caused by fusaria,aspergilli is as high as41.3%(71/172) and44.7%(21/47); the surgery rate of the patients infected by alternaria or other genera is6.6%(4/61) and11.4%(5/44)separately. The differences of the surgery rate among four groups are statisticallysignificant (χ2=37.459, P＜0.001). The surgery rate of fusaria or aspergilli is higherthan alternaria or other genera (χ2=24.871,13.749,21.688,12.361; P＜0.001); thedifferences of the surgery rate between fusaria and aspergilli, between alternaria andother genera are not statistically significant (χ2=0.175,0.753; P＞0.05). Thedifferences of the prognosis among groups are statistically significant (Hc=38.879, P＜0.001). The prognosis of fusaria or aspergilli is worse than alternaria or othergenera (P＜0.01); The differences between fusaria and aspergilli, or betweenalternaria and other genera are not statistically significant (P＞0.05). Among thepatients cured by medicines, the average period of using drugs of the patients infectedby fusaria, alternaria, aspergilli or other genera is （88±44）,（57±30）,（68±33）and（59±37）d sepatately. The differences of the average period of using drugs amongfour groups are statistically significant (F=10.221, P＜0.001). The period of usingdrugs of the patients infected by fusaria is longer than by alternaria, aspergilli or othergenera (P＜0.05). The average recovered visual acuity of the patients infected byfusaria, aspergilli, alternaria or other genera is0.65±0.26,0.64±0.26,0.82±0.21and0.75±0.27sepatetely. The differences of the recovered visual acuity among groups arestatistically significant (F=6.210, P＜0.001). The recovered visual acuity of thepatients infected by alternaria is better than by fusaria or aspergilli (P＜0.01). Thedifferences among the average diameter of lesions are statistically significant(Hc=52.471, P＜0.001), the average diameter of the lesions caused by fusaria oraspergilli is larger than by alternaria or other genera (P＜0.01), the differencesbetween fusaria and aspergilli, or between alternaria and other genera are notstatistically significant (P＞0.05).ConclusionsFusaria, alternaria and aspergilli are the predominant genera of fungal keratitis incentral China. The prognosis of fungal keratitis caused by fusaria or aspergilli isworse than alternaria or other genera do, and has the characteristics of higher virulence, worse effects of drug treatment, lengthier drug treatment, worse recoveredvisual acuity and higher rate of surgery.