Update on fungal keratitis

Abstract

Purpose of review: The aim of this review article is to present an overview of some of the seminal work published in the last 18 months (July 2014 to December 2015).

Recent findings: The published literature highlights the need for the identification of fungal isolates to species and subspecies level using molecular methods. Molecular methods helped us identify some of the unknown fungi such as Pythium - fungi that causes keratitis unresponsive to conventional antifungal therapy. Although not popular fungal in-vitro susceptibility tests are showing better correlation between resistance and clinical outcomes. Several groups are trying to understand host responses controlling disease production as well as inflammation. On therapy front researchers are working to develop drug formulations and delivery systems that will provide superior pharmacokinetics and bioavailability. Collagen cross-linking and injections of antifungal agents into the corneal stroma and anterior chamber continue to be attractive to clinicians and more and more researchers are publishing their experiences.

Summary: It is an interesting time in the history of mycotic keratitis with a lot of positive developments. Molecular methods will help improved diagnosis and clinico-therapeutic correlation. Drug delivery devices with superior pharmacokinetics are on horizon.