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Pauline Khoo, Maria Cabrera-Aguas, Kenneth Ooi, Stephanie L Watson; Microbiological and clinical profile of patients with ocular surface disease and microbial keratitis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3778.
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© ARVO (1962-2015); The Authors (2016-present)
To report the microbiological and clinical profile of patients with an ocular surface disease and microbial keratitis at a quaternary referral eye care centre.
A retrospective case series included of all patients with a clinical diagnosis of microbial keratitis and dry eye, blepharitis or meibomian gland dysfunction (MGD) undergoing corneal scraping at the Sydney Eye Hospital, Australia from January 2012 to December 2016. Cases were identified from pathology results and ICD-10 coding. Data was collected from the medical records. Visual acuity (VA) was recorded and converted from Snellen to logarithm of the minimum angle of resolution (logMAR). The final visit was when the infection had resolved. The clinical and microbiological profile, re-epithelialisation (healing time), and final outcome were evaluated.
181 cases of 169 patients with a mean age of 59.4 years (range 20 – 96 years) and male to female ratio of 1:0.97 were included. Blepharitis was reported in 148 cases (82%), dry eye in 48 (27%), and meibomian gland dysfunction (MGD) in 4 (2%). Of the 148 patients with blepharitis, 15 (10%) also had a clinical diagnosis of dry eye, 2 (1%) had MGD and 1 patient had a diagnosis of all 3 external eye diseases.123 (68%) cases had a positive microbiology result, the most common microorganisms identified were Staphylococcus epidermidis (n=36), Staphylococcus aureus (n=16), and Staphylococcus capitis (n=15). The mean ± standard deviation of the epithelial healing time for all patients was 21 ± 29 days (range 2 – 217 days). The mean change in BCVA from presentation to the final visit was 0.15 ± 0.38 (P < 0.001). The final BCVA was better than at presentation in 46% of patients, unchanged in 36% and worse in 18%. Adverse events occurred in 60 (33%) cases, most commonly a non-healing epithelial defect requiring a bandage contact lens (n=23, 38%) or temporary tarsorrhapy (n=17, 28%).
Microbial keratitis in patients with an ocular surface disease is usually caused by Staphylococcus spp. Delayed epithelial healing was a common complication in this group. There is a need for appropriate strategies to prevent the development of ocular surface disease, which is a known risk factor for microbial keratitis.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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