Format

Send to

Choose Destination
Am J Ophthalmol. 2018 Nov;195:161-170. doi: 10.1016/j.ajo.2018.07.040. Epub 2018 Aug 9.

The Asia Cornea Society Infectious Keratitis Study: A Prospective Multicenter Study of Infectious Keratitis in Asia.

Author information

1
Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, Singapore.
2
Aravind Eye Care System, Madurai, India.
3
L V Prasad Eye Institute, Hyderabad, India.
4
Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, Singapore; Duke-NUS Graduate Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
5
Shandong Eye Institute, Shandong, China.
6
Xiemen Eye Center, Xiemen, China.
7
University of the Philippines Manila, Philippine General Hospital, Manila, Philippines; St. Luke's Medical Center, Global City, Manila, Philippines.
8
St Mary Hospital, The Catholic University of Korea, Seoul, South Korea.
9
Division of Ophthalmology and Visual Science, Tottori University, Faculty of Medicine, Tottori Prefecture, Japan.
10
Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
11
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
12
Osaka University Graduate School of Medicine, Osaka University Hospital, Osaka, Japan.
13
Kyoto Prefectural University of Medicine, Kyoto, Japan.
14
King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
15
Department of Microbiology, Singapore General Hospital, Singapore.
16
Singapore Eye Research Institute, Singapore; Duke-NUS Graduate Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
17
Prince of Wales Hospital, The Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong.
18
Dr. Rajendra Prasad Centre Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
19
Duke-NUS Graduate Medical School, Singapore.
20
Scripps Clinic Torrey Pines, La Jolla, California, USA.
21
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Illinois, USA.
22
School of Optometry and Vision Science, University of New South Wales, New South Wales, Australia.
23
Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA.
24
Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, Singapore; Duke-NUS Graduate Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: donald.tan.t.h@singhealth.com.sg.

Abstract

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.

PMID:
30098351
DOI:
10.1016/j.ajo.2018.07.040
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center