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Susan Huang, Alessa Crossan, Grace Honik, David C Gritz; Epidemiology of Ulcerative Keratitis: Bronx Experience. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5467.
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To identify the epidemiological characteristics, predisposing factors, and the microbiological diagnosis of ulcerative keratitis in Bronx, New York.
A retrospective review of medical records with diagnosis coding for corneal ulcers during a three-year period between January 1, 2010 and December 31, 2012 was performed. Inclusion criteria were new diagnosis of ulcerative keratitis during the study period; diagnosis defined as a corneal epithelial defect with stromal inflammatory infiltrate secondary to bacterial, fungal, or parasitic cause; home zip code in Bronx; positive corneal cultures or response to therapy and clinical course consistent with infectious ulcerative keratitis; no evidence of stromal infiltrates secondary to viral, immune-mediated, or rheumatologic causes.
Of 351 cases with appropriate diagnosis coding, 120 patients met inclusion criteria. Ulcerative keratitis occurred with a mean age 41.8 with female predominance (53.3%). Most common ethnicities were Hispanic (39.2%), Black (30.8%), and Caucasian (14.2%). Most common predisposing risk factors were contact lens wear (51.7%), ocular surface disease (24.2%), previous ocular surgery (16.7%), and ocular trauma (14.2%). 5% cases were known HIV-positive. Positive cultures for Gram-positive and Gram-negative species yielded similar occurrence rate (50%, 50%), with coagulase-negative staphylococci as the most common Gram-positive isolate (20%) and Pseudomonas as the most common Gram-negative isolate (34%). Pseudomonas made up 66.7% of contact lens-related cases.
Ulcerative keratitis in this cohort from the Bronx more likely affected women, often due to contact lens use. There is a high predominance of Pseudomonas, especially with contact lens-related cases. This study offers insight into the epidemiology of ulcerative keratitis in an urban setting and contributes to the limited literature of HIV association with ulcerative keratitis.
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