DR. SAMRAT CHATTERJEE

Dr.Deepshikha Agrawal, Dr.Sharad Gomase

Abstract

Aim: To identify clinical signs which differentiate Pythium keratitis(PyK) from fungal keratitis(FK). Method: Clinical signs of PyK (n=27) were compared with FK (n=69). Univariate and multivariate analysis was performed. Results: Trauma history (p=0.05), plaque formation (0.044). Wessely ring (0.065) favored FK. Full thickness stromal infiltrate (p=0.05), dry surface (0.004), intra-stromal dot lesions (p<0.0001), tentacles(p<0.0001), reticular pattern(p<0.0001), ring infiltrate (0.024), reduced infiltrate density in centre (p<0.0001)and peripheral furrow (p<0.0001) favoured PyK. Multiple logistic regression: tentacles [odds ratio: 24.1 (95% CI:3.8 – 158.1), p=0.001) and peripheral furrow [odds ratio: 60.6 (95% CI:5.1 – 712.3), p=0.001) for PyK. Conclusion: PyK can be differentiated from FK clinically with above signs which can guide primary eye care workers to make empirical diagnosis, order microbiology workup, start appropriate therapy or timely referrals for overall better outcome

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