Purchase this article with an account.
Mamta Agarwal, Vicky Cevallos, Douglas Holsclaw, Thomas Lietman, Nisha Acharya, Bruce Gaynor, Jeremy keenan; The Prevalence Of Bacterial Pathogens On The Lids And Conjunctiva In Ocular Cicatricial Pemphigoid. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4250.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To determine the prevalence of bacterial pathogens on the lids & conjunctiva in biopsy proven Ocular Cicatricial Pemphigoid (OCP) and to identify factors which are associated with this colonization.
A retrospective chart review of all patients with biopsy proven OCP seen in UCSF/Proctor Foundation from 1995 to 2010. Several clinical features of the disease including entropion, trichiasis, keratinization of the eyelid margin and the conjunctiva, keratoconjunctivitis sicca, abnormal tear break-up time, fornix shortening and concurrent chemotherapy use were evaluated as predictors of pathogenic bacterial colonization.
The records of 29 patients with biopsy proven ocular cicatricial pemphigoid were retrospectively reviewed. There were 13 men (45%) and 16 women (55%) with a mean age of 60 years (range 14 - 81). Pathogenic bacteria on the eyelids or conjunctiva were seen in 48% (14/29) of patients.The most frequently cultured pathogens were Staphylococcus aureus and Streptococcus viridians which were found in 21% (6/29) of patients. The next most common organisms were Enterococcus (14%), Hemophillus (10%) and gram negative rods (7%).The presence of pathogenic bacteria was significantly associated with keratinization of conjunctiva and lids and trichiasis. Multivariate logistic regression analysis showed that the presence of pathogenic bacteria was independently associated with keratinization (p=0.05, 95% CI 0.02-3.3) and trichiasis p=0.003, 95% CI 1.2 -5.9).
There is a high prevalence of colonization with pathogenic bacteria in biopsy proven OCP. Conjunctival keratinization and trichiasis are significantly associated with this colonization. Identifying the risk factors associated with culture positivity gives a clinician additional means of identifying individuals likely to harbor pathogens. Such risk factors should be aggressively managed to prevent worsening of OCP.
This PDF is available to Subscribers Only