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Dilys Lola Oladiwura, Ore-Oluwa Erikitola, Sanjay Mantry, Kanna Ramaesh, Deepa Anijeet; Evaluation of Moraxella keratitis at a tertiary referral centre. Invest. Ophthalmol. Vis. Sci. 2016;57(12):334. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Moraxella keratitis is rare but leads to significant morbidity. This series evaluates the ocular and systemic risk factors associated with Moraxella keratitis, visual outcomes and the diversity of species of Moraxella involved in corneal infections.
This is a retrospective data analysis of culture proven cases of Moraxella keratitis during a 2year period (July 1st 2013 to July 31st 2015) at the Tennent Institute of ophthalmology Gartnavel General Hospital in Glasgow, Scotland.
15 episodes of Moraxella keratitis were identified in 14 patients. 13 (86.7%) eyes were positive for Moraxella nonliquefaciens while 2 eyes were positive for Moraxella lacunata. 1 (7.1%) patient had a recurrence of Moraxella keratitis. The average age of the patients was 69. One or more influencing ocular factors were identified in 9 (60%) eyes including: previous herpetic eye disease (n=2), corneal graft (n= 1), meibomian gland disease (n = 2), advanced glaucoma (n=2), bell's palsy (n =1), thyroid eye disease (n=1) and ectropion (n=2). Two patients had history of cancer, two patients with a history of alcohol abuse, one patient was a poorly controlled diabetic and another had a history of severe atopy.Overall 71.4% (n=10) had systemic and/or ocular risk factors. All patients had intensive topical cephalosporin combined with gentamicin and quinolone. One patient with concomitant active herpetic eye disease received topical acyclovir. All cultured species were sensitive to both ofloxacin and gentamicin. 4 cases showed additional sensitivity to chloramphenicol.93.3% of eyes (n=14) had adjuvant topical steroid therapy once clinical resolution was initiated. One eye (6.7%) developed corneal perforation requiring emergency keratoplasty. Other adjunctive treatment included: 6.7% (n=1) Botox ptosis, 13.3% (n=2) ectropion surgery. In 20% of eyes (n=3), polymicrobial infection was identified.4 patients had pre-existing vision of LogMAR 0.78 or worse. 40% of eyes had a final best corrected visual acuity of LogMAR 0.78 or worse (n=6). No eye with M. lacunata had a visual acuity worse than LogMAR 0.3 after treatment was complete.
Similar to other studies this cohort also finds ocular or systemic health status a factor in the pathogenesis of Moraxella keratitis. However, contact lens wear is not a risk factor in this series as some series indicate. M. nonliquefaciens may be associated with a worse visual outcome in this small series.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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