UCSF Ophthalmologists Help Characterize Fungal Eye Infections

In a recent report published online in Archives of Ophthalmology, Maria Bernal, MD, a clinical fellow at UCSF's Proctor Foundation, and David Hwang, MD, FACS, professor of clinical ophthalmology and director of the Cornea Service at UCSF, along with colleagues in UCSF's Department of Ophthalmology, provide one of the first reports of an outbreak of soft contact lens-associated corneal infections due to Fusarium, an uncommon type of fungus. All four patients in the report were seen during a five-week span in early 2006, and all had used either Bausch & Lomb ReNu MoistureLoc or ReNu MultiPlus contact lens solution. Reports from UCSF and other centers of a recent spike in Fusarium infections associated with use of ReNu contact lens solutions led to a manufacturer-initiated recall of ReNu with MoistureLoc solution in May 2006. "Our report strongly suggests that the current cluster represents an unusual spike over the background incidence of Fusarium-associated contact lens keratitis at our institution, since only two similar cases had been seen during the prior 30 years," said Bernal. "UCSF, other laboratories, and the Centers for Disease Control and Prevention are currently investigating the fungicidal properties of the contact lens solutions used by these patients and the genotype characteristics of the Fusarium isolates in an effort to determine the underlying cause of the current apparent outbreak and whether the Fusarium species from these cases originate from a common strain." According to the researchers, these infections can severely and permanently impair a patient's vision, as well as cause structural damage to the eye that may necessitate corneal transplantation, particularly if appropriate antifungal treatment is delayed. In the report, they also emphasize the importance of performing fungal cultures of the cornea to check for Fusarium, and of initiating prompt therapy with antifungal treatment, since the standard approach to the treatment of corneal infections involves the use of antibiotics that are typically ineffective against fungal organisms. To view the report online, click here. The research that led to the case reports was supported in part by unrestricted grants from Research to Prevent Blindness and That Man May See. Established in 1947, The Francis I. Proctor Foundation for Research in Ophthalmology is an internationally renowned, privately endowed Organized Research Unit at the University of California, San Francisco Medical Center. The foundation is dedicated to research and training in infectious and inflammatory ocular diseases, and the application of this research to the prevention of blindness worldwide. It is recognized as the preeminent center in the world for this discipline. The Beckman Vision Center at UCSF is internationally recognized for its excellence in all disciplines of ophthalmology. The Beckman Vision Center houses clinicians and researchers from the UCSF Department of Ophthalmology, who are dedicated to discovering the causes of visual loss, and to developing and applying new treatment and prevention strategies for blinding eye disease. Vision research and care at the Beckman Vision Center is supported by That Man May See, the philanthropic foundation of the UCSF Department of Ophthalmology.