Fungal Eye Infections: New Hosts, Novel Emerging Pathogens but No New Treatments?
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Purpose of Review
We sought to explore the current incidence and associated risk factors associated with fungal eye infections. We also reviewed new diagnostic strategies and recent clinical studies exploring the use of topical and oral antifungal agents.
Incidence and associated risks continue to vary with geographic region, and access to timely healthcare. Nosocomial fungal endophthalmitis can result from minor surgical procedures to the eye. Molecular methods offer increasing diagnostic utility. Clinical treatment studies have mainly focussed on the treatment of fungal keratitis and have been conducted in South Asia. Topical natamycin remains superior to topical reconstituted voriconazole and remains the preferred therapy including for Fusarium eye infections. Neither adjunctive oral ketoconazole nor oral voriconazole has been shown to have added clear benefit to topical treatment.
Larger international studies with more heterogenous populations are required for future clinical studies which should include patients with contact lens fungal keratitis and those with fungal endophthalmitis. Basic science studies exploring the immunology of fungal eye infections and drug levels to understand the differences in clinical outcomes are encouraged.
KeywordsFungal keratitis Fungal endophthalmitis Invasive fungal infection Contact lens infection Topical natamycin Voriconazole Mycotic ulcer
Compliance with Ethical Standards
Conflict of Interest
Christina C. Chang declares no conflict of interest. Sharon C-A Chen has received grant funding from MSD (AUS).
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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