Results From the German Fungal Keratitis Registry: Significant Differences Between Cases With and Without a History of Contact Lens Use

Mathias Roth, Christoph Holtmann, Loay Daas, Vinodh Kakkassery, Oliver Kurzai, Gerd Geerling, Sebastian Bäurle, Wesal Bayoudh, Viktoria Brücher, Nadezhda Cvetkova-Fischer, Matthias Dias Blak, Agnes Bornstein, Charlotte Fischer, Matthias Fuest, Salvatore Grisanti, Martina C. Herwig-Carl, Sandra Kroll, Janine Lenk, Claudia Lommatzsch, Colin R. MacKenzieMario Matthaei, Juliane Mehlan, Elisabeth M. Messmer, Violetta Müller, Vera Pawlik, Mahdy Ranjbar, Anna Renner-Wilde, Annekatrin Rickmann, Mark Saeger, Marc Schargus, Luisa Schwarz, Berthold Seitz, Friedrich Steindor, Jan Darius Unterlauf, Arne Viestenz, Marie von Lilienfeld-Toal, Grit Walther

1 Citation (Scopus)


PURPOSE: Fungal keratitis (FK) is a serious ophthalmic disease with a potentially devastating outcome that seems to be increasing in recent years. The use of contact lenses (CLs) was evaluated as a risk factor for FK to determine possible differences in course and outcome. METHODS: Data from 173 cases reported in the German FK registry until August 2019 were evaluated regarding CL behavior, other ophthalmological and general risk factors, age, sex, identified pathogens, conservative and surgical therapy, visual acuity, and findings at admission and follow-up. RESULTS: One hundred seventy-four eyes from 173 patients between 2000 and 2019 were included [64.4% women, median age 54 (39; 72) years]; 49.7% wore CL, of which 81.3% were soft CL, and 50.3% had no history of contact lens use (NCL). CL users were significantly more often women and otherwise healthy (CL: 80.2% vs. NCL: 48.9%; P < 0.0001). The spectrum of pathogens among CL users showed a significantly higher proportion of infections with filamentous pathogens, in particular Fusarium sp. (total filament: CL 69.8% vs. NCL 27.3%; P = 0.0001; Fusarium sp.: CL 50.0% vs. NCL 14.8%; P < 0.0001). Overall, 54.6% required keratoplasty and 8.6% enucleation. CONCLUSIONS: CLS are the most important risk factor for FK in Germany. With CLs, typically, the infection is caused by molds, and patients are comparably younger and otherwise healthy. Often, extensive surgery is needed. To evaluate changes in the pathogen and resistance spectrum and to further monitor possible CL-related risk factors, a consistent collection of data remains paramount.

Original languageEnglish
Issue number11
Pages (from-to)1453-1461
Number of pages9
Publication statusPublished - 01.11.2021


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