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Polymerase chain reaction yields fast, sensitive diagnosis of fungal keratitis

Invest Ophthalmol Vis Sci. 2009;50(1):152-156.

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Polymerase chain reaction was found to be more sensitive than culture in detecting fungal keratitis, and results were obtained in only 4 to 8 hours. Culture for detecting mycotic keratitis has been considered the gold standard, but results take 5 to 7 days.

In a study of 40 patients with presumed fungal corneal ulcers in India, where infective corneal ulcer is a major cause of ocular morbidity, polymerase chain reaction (PCR) results were compared with culture, KOH wet mount smear and Gram stain. PCR had a positivity of 50% in the 40 cases, KOH was 40%, Gram stain was 35% and culture was 25%. PCR yielded sensitivity of 70%, whereas KOH and Gram stain yielded sensitivities of 60% and 40%, respectively.

PCR primers were targeted to a sequence common to all fungi that cause corneal infections in tropical climates.

"PCR remains a promising tool for faster diagnoses of fungal keratitis," the study authors said, although its routine use in India and other developing countries is limited by cost.