목적: Candida 각막염의 역학과 선행인자, 임상양상 및 치료 결과를 알아보고자 하였다. 대상과 방법: 영남대학교병원에서 18년간(2000-2017) 감염각막염으로 치료한 환자 중 미생물 배양검사에서 Candida가 동정된 18안(C. albicans [CA] 9안, non-CA [NCA] 9안)을 대상으로 역학, 선행인자, 임상양상 및 치료 결과를 후향적으로 조사하였다. 치료 성공은 약물 치료로 각막상피재생이 완료된 경우로 정의하였다. 결과: 평균나이는 67.5 ± 15.4세, 복합감염은 7안(39%)이었다. 평균 증상내원 기간은 23.9일이었다. 선행인자로 이전 안구표면 질환(8안, 44%), 각막외상(8안, 44%) 및 점안 스테로이드 사용(7안, 39%)이 흔했다. 임상양상으로 원형(13안, 72%)의 기질 침윤과 전방축농(8안, 44%)이 흔하였고 초진시력 0.1 미만은 13안(72%)이었다. 치료 결과로 평균 상피재생 기간 23.5 ± 18.9일, 최종시력 0.1 미만 12안(75%) 및 치료 성공 6안(35%)을 보였다. 수술 치료는 11안(61%)에서 시행되었으며, 그중 5안은 안구적출술이었다. CA와 NCA 사이에 임상양상 및 치료 결과의 유의한 차이는 없었다. 치료 실패군에서 치료 성공군에 비해 이전 스테로이드 사용(64% vs. 0%, p=0.04)이 많았고 긴 증상내원 기간(31.3일 vs. 13.5일, p=0.08)을 보였다. 결론: Candida 각막염은 고령 및 이전 안질환력과 관계 있었으며, 수술적 치료가 흔히 시행되었다. 치료 실패군에서 치료 성공군에 비해 이전 스테로이드 사용 및 긴 증상내원 기간과 더 관련이 있었다.
Purpose: To investigate the epidemiology, predisposing factors, clinical characteristics, and treatment results of Candida species keratitis. Methods: Eighteen eyes of 18 patients who were diagnosed with Candida species keratitis (C. albicans [CA], 9 eyes; non-CA [NCA], 9 eyes) via corneal culture and hospitalized at Yeungnam University Hospital were included. The epidemiology, predisposing factors, initial clinical characteristics, and treatment outcomes were analyzed retrospectively. Treatment success was defined as the successful healing of corneal lesions after medical intervention. Results: The mean age was 67.5 ± 15.4 years and polymicrobial infection was observed in seven eyes (39%). The mean duration of symptoms was 23.9 days. The common predisposing factors were previous ocular surface disease (8 eyes, 44%), corneal trauma (8 eyes, 44%), and previous topical steroid use (7 eyes, 39%). Common initial clinical characteristics were round infiltration (13 eyes, 72%), hypopyon (8 eyes, 44%), and an initial best corrected visual acuity (BCVA) of less than 0.1 (13 eyes, 72%). In terms of treatment outcomes, we recorded a mean corneal epithelial healing time of 23.5 ± 18.9 days, a final BCVA <0.1 in 12 eyes (75%), and treatment success in 6 eyes (35%). Surgical treatments were performed in 11 eyes (61%), five of which experienced evisceration or enucleation. There were no significant differences in clinical characteristics or treatment outcomes between the CA and NCA groups. In the treatment failure group, previous topical steroid use (64% vs. 0%, p = 0.04) was more common and symptom durations were relatively longer than in the treatment success group (31.3 vs. 13.5 days, p = 0.08). Conclusions: Our results showed that Candida keratitis is associated with old age, previous ocular disease, and surgical treatment. Compared with the group in which successful outcomes were achieved, the treatment failure group was associated with previous topical steroid use and longer symptom duration.
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