Abstract

Volume.120 Number.9

Original article : Case report

A Case of Fungal Keratitis Treated Surgically
Koji Kitazawa1,2,3, Eri Kondo1, Chie Sotozono3, Shigeru Kinoshita1,2
1 Baptist Eye Institute
2 Department of Frontier Medical Technology for Ophthalmology, Kyoto Prefectural University of Medicine
3 Department of Ophthalmology, Kyoto Prefectural University of Medicine

Purpose: Here we report a patient who underwent removal of a retrocorneal plaque and anterior chamber irrigation for acute-stage fungal keratitis.
Case report: A 56-year-old woman was referred to the Baptist Yamasaki Eye Clinic, Kyoto, Japan due to refractory infectious keratitis. A white plume infiltration from the superficial to deep corneal stroma was present at the central cornea, and a white giant plaque was present on the posterior surface of the cornea. For diagnostic purposes and to reduce inflammation, the retrocorneal plaque was surgically removed and the anterior chamber was irrigated. Findings obtained from the surgically removed plaque revealed many neutrophils coiled with fibrin and filamentous fungus positive to Fungiflora Y staining. At 1-day postoperative, the amount of inflammation and infiltration were drastically decreased and the infection focus became gradually becoming smaller, finally disappearing at 6-weeks postoperative and with no signs of recurrence.
Conclusion: The findings of this study show that surgical intervention can be an effective treatment option for cases of fungal keratitis with retrocorneal plaque.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 120: 640-645, 2016.

Key words
Fungal keratitis, Surgery, Anterior chamber irrigation, Fungiflora Y staining, Retrocorneal plaque
Reprint requests to
Koji Kitazawa, M.D. Baptist Eye Institute. 12 Kamiikeda-cho, Kitashirakawa, Sakyo-ku, Kyoto 606-8287, Japan