American journal of ophthalmology · 2018
The Asia Cornea Society Infectious Keratitis Study: A Prospective Multicenter Study of Infectious Keratitis in Asia.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Khor Wei-Boon, Prajna Venkatesh N, Garg Prashant, Mehta Jodhbir S, Xie Lixin, Liu Zuguo, Padilla Ma Dominga B, Joo Choun-Ki, Inoue Yoshitsugu, Goseyarakwong Panida, Hu Fung-Rong, Nishida Kohji, Kinoshita Shigeru, Puangsricharern Vilavun, Tan Ai-Ling, Beuerman Roger, Young Alvin, Sharma Namrata, Haaland Benjamin, Mah Francis S, Tu Elmer Y, Stapleton Fiona J, Abbott Richard L, Tan Donald Tiang-Hwee, ACSIKS Group
Аннотация
PURPOSE: To survey the demographics, risk factors, microbiology, and outcomes for infectious keratitis in Asia.
DESIGN: Prospective, nonrandomized clinical study.
METHODS: Thirteen study centers and 30 sub-centers recruited consecutive subjects over 12-18 months, and performed standardized data collection. A microbiological protocol standardized the processing and reporting of all isolates. Treatment of the infectious keratitis was decided by the managing ophthalmologist. Subjects were observed for up to 6 months. Main outcome measures were final visual acuity and the need for surgery during infection.
RESULTS: A total of 6626 eyes of 6563 subjects were studied. The majority of subjects were male (n = 3992). Trauma (n = 2279, 34.7%) and contact lens wear (n = 704, 10.7%) were the commonest risk factors. Overall, bacterial keratitis was diagnosed in 2521 eyes (38.0%) and fungal keratitis in 2166 eyes (32.7%). Of the 2831 microorganisms isolated, the most common were Fusarium species (n = 518, 18.3%), Pseudomonas aeruginosa (n = 302, 10.7%), and Aspergillus flavus (n = 236, 8.3%). Cornea transplantation was performed in 628 eyes to manage ongoing infection, but 289 grafts (46%) had failed by the end of the study. Moderate visual impairment (Snellen vision less than 20/60) was documented in 3478 eyes (53.6%).
CONCLUSION: Demographic and risk factors for infection vary by country, but infections occur predominantly in male subjects and are frequently related to trauma. Overall, a similar percentage of bacterial and fungal infections were diagnosed in this study. Visual recovery after infectious keratitis is guarded, and corneal transplantation for active infection is associated with a high failure rate.
DESIGN: Prospective, nonrandomized clinical study.
METHODS: Thirteen study centers and 30 sub-centers recruited consecutive subjects over 12-18 months, and performed standardized data collection. A microbiological protocol standardized the processing and reporting of all isolates. Treatment of the infectious keratitis was decided by the managing ophthalmologist. Subjects were observed for up to 6 months. Main outcome measures were final visual acuity and the need for surgery during infection.
RESULTS: A total of 6626 eyes of 6563 subjects were studied. The majority of subjects were male (n = 3992). Trauma (n = 2279, 34.7%) and contact lens wear (n = 704, 10.7%) were the commonest risk factors. Overall, bacterial keratitis was diagnosed in 2521 eyes (38.0%) and fungal keratitis in 2166 eyes (32.7%). Of the 2831 microorganisms isolated, the most common were Fusarium species (n = 518, 18.3%), Pseudomonas aeruginosa (n = 302, 10.7%), and Aspergillus flavus (n = 236, 8.3%). Cornea transplantation was performed in 628 eyes to manage ongoing infection, but 289 grafts (46%) had failed by the end of the study. Moderate visual impairment (Snellen vision less than 20/60) was documented in 3478 eyes (53.6%).
CONCLUSION: Demographic and risk factors for infection vary by country, but infections occur predominantly in male subjects and are frequently related to trauma. Overall, a similar percentage of bacterial and fungal infections were diagnosed in this study. Visual recovery after infectious keratitis is guarded, and corneal transplantation for active infection is associated with a high failure rate.
Предметные рубрики MeSH
AdolescentAdultAge DistributionAgedAged, 80 and overAnti-Bacterial AgentsAntifungal AgentsAsiaBacteriaChildChild, PreschoolCorneal UlcerEye Infections, BacterialEye Infections, FungalFemaleFungiHumansInfantInfant, NewbornMaleMiddle AgedOphthalmologyProspective StudiesRisk FactorsSex DistributionSocieties, MedicalVisual Acuity