Microsporidial Keratoconjunctivitis in South India - Various Presentations, Role of Therapeutic Debridement and Topical Voriconazole

Abstract

Purpose: To report various presentations and the effect of therapeutic debridement with topical Voriconazole in Microsporidial epithelial keratitis Design: Retrospective analysis Methods and Material: 33 eyes of 32 patients of clinically and microbiologically proven Microsporidial epithelial keratitis were included. Diagnosis was done with Gram staining and confirmed by modified Ziehl Neelsen (1% Acid fast). All lesions were therapeutically debrided and 1% topical voriconazole was given and followed up weekly until resolution. Results: The mean age of our patients was 32 years (Range: 10-68 years). The disease was more common in young adults (21-30 years age group). All patients had undergone therapeutic debridement and prescribed 1% topical voriconazole and were symptomatically better. Visual acuity ranged from log MAR 0.6 to log MAR 0.00 which further improved after resolution. Significant visual loss did not occur in any patient. Conclusion: Microsporidial epithelial keratitis is more common than expected in young, healthy individuals including doctors and are typically confused with viral keratitis. The disease showed complete resolution with no recurrence with therapeutic debridement and topical voriconazole therapy.

Keywords

• microsporiadial keratitis
• topical voriconazole therapy
• therapeutic debridement
• microsporidiosis