مرور نظام مند مطالعات گزارش‌ موردی و سری های موردی میکروسپوریدیوز چشمی در انسان

Introduction: Microsporidia, a rare opportunistic organism often misidentified in corneal infections, constitutes approximately 0.4% of microbial keratitis cases in certain populations. The aim of the present study is to conduct a systematic analysis of case reports and case series of ocular microsporidiosis in humans for the first time.
Methods: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Defined terms as Medical Subject Headings (MeSH) keywords were searched from 2017 to the end of 2023 in the scientific databases PubMed/MEDLINE, Embase, Web of Science and Cochrane Library. Case reports and case series in English or English abstracts related to ocular microsporidiosis in humans were included in the study.
Results: Finally, 28 studies including 426 participants were systematically reviewed. Several risk factors were identified, such as exposure to contaminated water and soil, corticosteroid use, and underlying diseases (e.g., diabetes or kidney transplantation). The main clinical features included redness, blurred vision, and photophobia, accompanied by varying pathological findings in the cornea. Also, treatment outcomes were diverse, ranging from full recovery with medication to the need for penetrating keratoplasty (corneal transplantation) in resistant cases were also observed.
Conclusion
This review demonstrated that ocular microsporidiosis is associated with a broad spectrum of clinical manifestations and treatment outcomes. Therefore, successful management of this infection necessitates a meticulous assessment of the patient’s risk factors and the customization of a specific treatment plan, ranging from pharmacotherapy to surgical intervention, to prevent recurrence and achieve the best visual outcome.