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M. B. Daluvoy, K. M. Hammersmith, C. Rapuano, E. S. Chen, E. J. Cohen, N. Ghaznawi, A. Saini; Corneal Infections in the Setting of Epithelial Basement Membrane Dystrophy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2885.
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© ARVO (1962-2015); The Authors (2016-present)
To describe infectious keratitis due to underlying epithelial basement membrane dystrophy(EBMD).
A retrospective chart review of patients with infectious keratitis secondary to EBMD from 1/1/2007 to 9/30/2009 at a tertiary care center was done. Patients with recent trauma, edema, or contact lens wear were excluded.
Ten patients with infectious keratitis due to underlying EBMD changes were identified. The average age at onset of the infection was 64.2+/-13.4 years; 60% were female. All cases had unilateral infections;90% had EBMD in both eyes;70% had a history of recurrent erosion syndrome(RES). Clinical findings included infiltrate(100%), epithelial defect(90%), hypopyon(30%), and stromal edema(70%). All were treated with topical antibiotics, 50% were cultured, 20% were treated with a bandage contact lens and one patient was hospitalized for corneal perforation. Of those cultured, 4 patients required fortified antibiotics/antifungals. Pathogens included S. aureus, S. epidermidis, P. aeruginosa, and candida.
EBMD is a known risk factor for RES, however its role in infectious keratitis may be under-recognized. This case series shows that EBMD can be complicated by severe corneal ulcers caused by various organisms. When counseling patients regarding the prognosis and treatment of EBMD, ophthalmologists should consider the possibility of infectious complications.
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