Purchase this article with an account.
Jogin Jose, Maria Soledad Cortina, Jose de la Cruz, Ali R Djalilian, Sandeep Jain, Joel Sugar, Elmer Tu, Ann-Marie Lobo; Visual outcomes and corneal surgery in patients diagnosed with herpetic stromal keratitis based on race. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4791.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Racial disparities exist in the medical treatment and progression of ocular diseases such as diabetic retinopathy, glaucoma, rhegmatogenous retinal detachments and corneal disease. African American patients are less likely to receive keratoplasty for conditions such as Fuchs endothelial dystrophy and are more likely to have corneal graft failure. This study investigated if underlying racial disparities are present in patients with herpetic stromal keratitis (HSK), including visual outcomes and corneal surgery. We hypothesized that non-white patients diagnosed with HSK would have worse visual prognosis and higher rates of corneal surgeries than white patients.
We performed a retrospective medical chart review of patients from the Illinois Ear and Eye Infirmary with ICD-9 code 054.43 (herpes simplex disciform keratitis) from 2010-2015. Patient age, sex, race, logMAR visual acuity (VA) and medication use at initial presentation, 1 month, 6 months, and 1 year follow up, corneal transplant, and other ocular surgeries were recorded.
Sixty-seven patients were confirmed to have HSK. Thirty-seven patients were white (55.2%) and 30 patients were non-white (44.7%) (6 African American, 4 Hispanic, 4 Asian, and 15 Other). There was no significant difference in logMAR VA between whites and non-whites at initial presentation, 1 month, and 1 year follow up, respectively (0.48 vs. 0.5, p=0.86, 0.20 vs 0.31, p=0.40, 0.29 vs. 0.44, p=0.39). There was a significant difference in VA between whites and non-whites at 6 month follow up (logMAR 0.17 vs. 0.65, p=0.04). A total of 5 non-white patients and 4 white patients had corneal transplants during the study period (p=0.5).
White and non-white patients diagnosed with herpetic stromal keratitis did not show significant differences in rates of corneal surgery or visual outcomes except at 6 month follow up where non-whites had decreased VA compared to whites. Small sample size and variable follow up limit the generalizability of these findings. Larger studies are necessary to determine if true racial disparities exist in herpetic keratitis, including disease course, visual and surgical outcomes.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
This PDF is available to Subscribers Only