The Role of OCT in Follow-Up of Fungal Keratitis Caused by Beauveria bassiana in Contact Lens Wearer

TL;DR

This paper discusses the use of OCT in diagnosing and monitoring fungal keratitis caused by Beauveria bassiana in a contact lens wearer.

Contribution

Highlights the role of AS-OCT in managing fungal keratitis caused by an unusual pathogen, Beauveria bassiana.

Findings

AS-OCT can assess evolution and monitor response to treatment in fungal keratitis.

Beauveria bassiana is an unusual but increasingly reported cause of fungal keratitis.

OCT can help in diagnosing fungal keratitis and planning post-infection therapy.

Abstract

A 25-year-old Caucasic female was referred to our clinic after suffering from infectious keratitis in the right eye for a month. The patient was a contact lens user and had no history of ocular trauma. Furthermore, the patient did not report any relevant antecedent. The main complaint was intense photophobia and pain. Infectious keratitis remains one of the main complications of contact lens wear and can become a therapeutic challenge in some patients. Although the most frequent causal agent is bacterial, other causes such as herpes virus, Acanthamoeba or fungi should be considered when antimicrobial therapy does not work as expected clinically. Fungal keratitis normally appears on previously damaged corneas, but it can also develop in contact lens wearers. Beauveria bassiana is an unusual pathogen which has been diagnosed more frequently lately per the clinical reports in the last 30 years, so it can be included in the diagnostic scheme when a fungal keratitis is suspected. In clinical management, AS-OCT may be a functional tool to assess the evolution and monitor the response to microbial agents and surgery. Although more studies are needed, some characteristic features have been described and can help to diagnose a fungal keratitis against other infections. AS-OCT can also play an important role in monitoring the corneal scarring after the keratitis episode, and it may be useful to plan post-infection therapy for visual rehabilitation.

Figures