Die Fusarien-Keratitis auf dem Vormarsch – eine aktuelle klinische Übersicht

Zusammenfassung

Die Keratitis durch Fusarien stellt in Deutschland ein insgesamt seltenes, aber durch seinen raschen Krankheitsverlauf, die meist verspätete Diagnosestellung und die eingeschränkten konservativen Behandlungsoptionen mittels antimykotischer Therapie ein ernst zu nehmendes Krankheitsbild mit potenziell visusbedrohendem Verlauf dar. Durch die zunehmende Anwendung von Kontaktlinsen und möglicherweise durch die veränderten klimatischen Bedingungen ist ein weiterer Anstieg der Fallzahlen in Deutschland zu erwarten. Das rechtzeitige Erkennen und Einleiten der antimykotischen Therapie und bei ausbleibender Besserung die frühzeitige Durchführung einer notfallmäßigen Keratoplastik sind hierbei maßgeblich für den Therapieerfolg.

Schlüsselwörter

Fusarium - Fusarien-Keratitis - Keratomykose - Pilzkeratitis - Kontaktlinsen - kontaktlinsenassoziierte Keratitis

• References/Literatur

• 1 Hoffman JJ, Burton MJ, Leck A. Mycotic Keratitis-A Global Threat from the Filamentous Fungi. J Fungi (Basel) 2021; 7: 273
• 2 Lin Y, Zhang J, Han X. et al. A retrospective study of the spectrum of fungal keratitis in southeastern China. Ann Palliat Med 2021; 10: 9480-9487
• 3 Behrens-Baumann W, Finis D, MacKenzie C. et al. [Keratomycosis – Therapy Standards and New Developments]. Klin Monbl Augenheilkd 2015; 232: 754-764
• 4 Roth M, Daas L, Renner-Wilde A. et al. [The German keratomycosis registry: Initial results of a multicenter survey]. Ophthalmologe 2019; 116: 957-966
• 5 Seitz B, Geerling G, Maier P. [Infectious Keratitis: Herpes under Control, Acanthamoeba and Fusarium on the Rise]. Klin Monbl Augenheilkd 2015; 232: 735-737
• 6 Szaliński M, Zgryźzniak A, Rubisz I. et al. Fusarium Keratitis–Review of Current Treatment Possibilities. J Clin Med 2021; 10: 5468
• 7 Ahmadikia K, Aghaei Gharehbolagh S, Fallah B. et al. Distribution, Prevalence, and Causative Agents of Fungal Keratitis: A Systematic Review and Meta-Analysis (1990 to 2020). Front Cell Infect Microbiol 2021; 11: 698780
• 8 Brown L, Leck AK, Gichangi M. et al. The global incidence and diagnosis of fungal keratitis. Lancet Infect Dis 2021; 21: e49-e57
• 9 Tuft SJ, Tullo AB. Fungal keratitis in the United Kingdom 2003–2005. Eye (Lond) 2009; 23: 1308-1313
• 10 Joseph J, Karoliya R, Sheba E. et al. Trends in the Microbiological Spectrum of Nonviral Keratitis at a Single Tertiary Care Ophthalmic Hospital in India: A Review of 30 years. Cornea 2023; 42: 837-846
• 11 Augustin VA, Weller JM, Kruse FE. et al. Fungal Interface Keratitis After Descemet Membrane Endothelial Keratoplasty. Cornea 2018; 37: 1366-1369
• 12 Donovan C, Arenas E, Ayyala RS. et al. Fungal keratitis: Mechanisms of infection and management strategies. Surv Ophthalmol 2022; 67: 758-769
• 13 Ong HS, Fung SSM, Macleod D. et al. Altered Patterns of Fungal Keratitis at a London Ophthalmic Referral Hospital: An Eight-Year Retrospective Observational Study. Am J Ophthalmol 2016; 168: 227-236
• 14 Oliveira Dos Santos C, Kolwijck E, van Rooij J. et al. Epidemiology and Clinical Management of Fusarium keratitis in the Netherlands, 2005–2016. Front Cell Infect Microbiol 2020; 10: 133
• 15 Roth M, Holtmann C, Daas L. et al. Results From the German Fungal Keratitis Registry: Significant Differences Between Cases With and Without a History of Contact Lens Use. Cornea 2021; 40: 1453-1461
• 16 Kovalchuk B, Khoramnia R, Tóth M. et al. [Fusarium Keratitis-an upcoming threat in Germany?]. Ophthalmologie 2022; 119: 1022-1034
• 17 Walther G, Stasch S, Kaerger K. et al. Fusarium Keratitis in Germany. J Clin Microbiol 2017; 55: 2983-2995
• 18 Walther G, Zimmermann A, Theuersbacher J. et al. Eye Infections Caused by Filamentous Fungi: Spectrum and Antifungal Susceptibility of the Prevailing Agents in Germany. J Fungi (Basel) 2021; 7: 511
• 19 Berger T, Seitz B, Flockerzi F. et al. Recurrent Filamentous Fungal Keratitis Caused When the Primarily Selected Graft Diameter was Too Small. Klin Monbl Augenheilkd 2022;
• 20 Dursun D, Fernandez V, Miller D. et al. Advanced fusarium keratitis progressing to endophthalmitis. Cornea 2003; 22: 300-303
• 21 Lupia T, Corcione S, Fea AM. et al. Exogenous Fungal Endophthalmitis: Clues to Aspergillus Aetiology with a Pharmacological Perspective. Microorganisms 2020; 9: 74
• 22 Winiarczyk M, Borkowska A, Mackiewicz J. Fusarium keratitis as a growing problem – case report and literature review. Ann Agric Environ Med 2021; 28: 409-413
• 23 Naumann G, Green WR, Zimmerman LE. A histopathologic study of 73 cases. Am J Ophthalmol 1967; 64: 668-682
• 24 Al-Hatmi AMS, Curfs-Breuker I, de Hoog GS. et al. Antifungal Susceptibility Testing of Fusarium: A Practical Approach. J Fungi (Basel) 2017; 3: 19
• 25 OʼDonnell K, Sutton DA, Rinaldi MG. et al. Internet-accessible DNA sequence database for identifying fusaria from human and animal infections. J Clin Microbiol 2010; 48: 3708-3718
• 26 Kheirkhah A, Syed ZA, Satitpitakul V. et al. Sensitivity and Specificity of Laser-Scanning In Vivo Confocal Microscopy for Filamentous Fungal Keratitis: Role of Observer Experience. Am J Ophthalmol 2017; 179: 81-89
• 27 Prajna NV, Krishnan T, Mascarenhas J. et al. The mycotic ulcer treatment trial: a randomized trial comparing natamycin vs. voriconazole. JAMA Ophthalmol 2013; 131: 422-429
• 28 Sharma S, Das S, Virdi A. et al. Re-appraisal of topical 1 % voriconazole and 5 % natamycin in the treatment of fungal keratitis in a randomised trial. Br J Ophthalmol 2015; 99: 1190-1195
• 29 Prajna NV, Krishnan T, Rajaraman R. et al. Effect of Oral Voriconazole on Fungal Keratitis in the Mycotic Ulcer Treatment Trial II (MUTT II): A Randomized Clinical Trial. JAMA Ophthalmol 2016; 134: 1365-1372
• 30 Lalitha P, Shapiro BL, Loh AR. et al. Amphotericin B and natamycin are not synergistic in vitro against Fusarium and Aspergillus spp. isolated from keratitis. Br J Ophthalmol 2011; 95: 744-745
• 31 Al-Hatmi AM, Meletiadis J, Curfs-Breuker I. et al. In vitro combinations of natamycin with voriconazole, itraconazole and micafungin against clinical Fusarium strains causing keratitis. J Antimicrob Chemother 2016; 71: 953-955
• 32 Kalavathy CM, Parmar P, Kaliamurthy J. et al. Comparison of topical itraconazole 1 % with topical natamycin 5 % for the treatment of filamentous fungal keratitis. Cornea 2005; 24: 449-452
• 33 Sharma N, Bagga B, Singhal D. et al. Fungal keratitis: A review of clinical presentations, treatment strategies and outcomes. Ocul Surf 2022; 24: 22-30
• 34 [Anonymous] Natacyn Prices, Coupons and Patient Assistance Programs. Im Internet (Stand: 03.01.2023): https://www.drugs.com/price-guide/natacyn
• 35 [Anonymous] Natamycin Price of 10 Brands. Im Internet (Stand: 03.01.2023): https://www.medindia.net/drug-price/natamycin.htm
• 36 Nejabat M, Yaqubi N, Khosravi A. et al. Therapeutic Effect of Intrastromal Voriconazole, Topical Voriconazole, and Topical Natamycin on Fusarium Keratitis in Rabbit. J Ophthalmol 2016; 2016: 8692830
• 37 Kalaiselvi G, Narayana S, Krishnan T. et al. Intrastromal voriconazole for deep recalcitrant fungal keratitis: a case series. Br J Ophthalmol 2015; 99: 195-198
• 38 Saluja G, Sharma N, Agarwal R. et al. Comparison of Safety and Efficacy of Intrastromal Injections of Voriconazole, Amphotericin B and Natamycin in Cases of Recalcitrant Fungal Keratitis: A Randomized Controlled Trial. Clin Ophthalmol 2021; 15: 2437-2446
• 39 Narayana S, Krishnan T, Ramakrishnan S. et al. Mycotic Antimicrobial Localized Injection: A Randomized Clinical Trial Evaluating Intrastromal Injection of Voriconazole. Ophthalmology 2019; 126: 1084-1089
• 40 Sharma N, Chacko J, Velpandian T. et al. Comparative evaluation of topical versus intrastromal voriconazole as an adjunct to natamycin in recalcitrant fungal keratitis. Ophthalmology 2013; 120: 677-681
• 41 Alfaro Rangel R, Szentmáry N, Lepper S. et al. Large-Diameter Penetrating Keratoplasties are Mostly Due to Very Severe Infectious Keratitis and Cannot Always Prevent Secondary Enucleation. Klin Monbl Augenheilkd 2022; 239: 1361-1368
• 42 Gong Y, Xin M. Incidence of recurrent fungal keratitis after primary keratoplasty and visual outcome and prognosis after intervention for the recurrence. Medicine (Baltimore) 2019; 98: e15910
• 43 Wei A, Wang K, Wang Y. et al. Evaluation of corneal cross-linking as adjuvant therapy for the management of fungal keratitis. Graefes Arch Clin Exp Ophthalmol 2019; 257: 1443-1452
• 44 Balparda K, Mejia-Turizo JC, Herrera-Chalarca T. Simultaneous Noncentered Photoactivated Chromophore for Keratitis-Corneal Collagen Cross-Linking and Penetrating Keratoplasty for Treatment of Severe Marginal Fusarium spp. Keratitis: A Description of a New Surgical Technique. Case Rep Ophthalmol Med 2017; 2017: 6987896
• 45 Uddaraju M, Mascarenhas J, Das MR. et al. Corneal Cross-linking as an Adjuvant Therapy in the Management of Recalcitrant Deep Stromal Fungal Keratitis: A Randomized Trial. Am J Ophthalmol 2015; 160: 131-134.e5
• 46 Ting DSJ, Henein C, Said DG. et al. Re: Prajna et al.: Cross-Linking-Assisted Infection Reduction (CLAIR): A randomized clinical trial evaluating the effect of adjuvant cross-linking on outcomes in fungal keratitis (Ophthalmology 2020; 127: 159–166). Ophthalmology 2020; 127: e55-e56
• 47 Hafezi F, Torres-Netto EA, Hillen MJP. Re: Prajna et al.: Cross-Linking-Assisted Infection Reduction: a randomized clinical trial evaluating the effect of adjuvant cross-linking on outcomes in fungal keratitis (Ophthalmology 2020; 127: 159–166). Ophthalmology 2021; 128: e6
• 48 Zhang ZY. Corneal cross-linking for the treatment of fungal keratitis. Cornea 2013; 32: 217-218
• 49 Martinez JD, Arrieta E, Naranjo A. et al. Rose Bengal Photodynamic Antimicrobial Therapy: A Pilot Safety Study. Cornea 2021; 40: 1036-1043
• 50 Mundra J, Dhakal R, Mohamed A. et al. Outcomes of therapeutic penetrating keratoplasty in 198 eyes with fungal keratitis. Indian J Ophthalmol 2019; 67: 1599-1605
• 51 Radhakrishnan N, Pathak N, Subramanian KR. et al. Comparative study on costs incurred for treatment of patients with bacterial and fungal keratitis – A retrospective analysis. Indian J Ophthalmol 2022; 70: 1191-1195
• 52 Lin HC, Lin JL, Lin-Tan DT. et al. Early keratectomy in the treatment of moderate Fusarium keratitis. PLoS One 2012; 7: e42126
• 53 Sun CQ, Lalitha P, Prajna NV. et al. Association between in vitro susceptibility to natamycin and voriconazole and clinical outcomes in fungal keratitis. Ophthalmology 2014; 121: 1495-1500.e1