July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Presenting clinical, microbiological and treatment characteristics of contact lens related corneal infections in Asia
Author Affiliations & Notes
  • Chris Hong Long Lim
    Department of Ophthalmology, National University Hospital, Singapore, Singapore
    School of Optometry and Vision Sciences, University of New South Wales, Sydney, New South Wales, Australia
  • Jodhbir S Mehta
    Singapore National Eye Centre, Singapore
    Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore
  • Fiona Stapleton
    School of Optometry and Vision Sciences, University of New South Wales, Sydney, New South Wales, Australia
  • Footnotes
    Commercial Relationships   Chris Lim, None; Jodhbir Mehta, None; Fiona Stapleton, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6353. doi:https://doi.org/
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      Chris Hong Long Lim, Jodhbir S Mehta, Fiona Stapleton; Presenting clinical, microbiological and treatment characteristics of contact lens related corneal infections in Asia. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6353. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To describe presenting clinical, microbiological and treatment characteristics of patients presenting with contact lens related corneal infections in Asia.

Methods : This was performed as part of the ACSIKS surveillance multisite study of non-viral infectious keratitis involving 9 countries and 11 sites across South East Asia. The study was carried out between 2012–2014. Comparisons were performed by examining proportions, one-way ANOVA or chi-squared testing as necessary

Results : 702 cases were identified. This comprised 10.7% of the total cases. The median age of lens wearers was 25 years (range 11 to 79). Sixty-eight percent were female (P<0.001). The median duration to presentation was 2 days (range 0 to 90), with significant differences between countries (P=0.001). Mean presenting visual acuity (LogMAR) was 0.49±0.59. 177 (25%) patients received treatment prior to presenting at recruitment sites. Of these, 177 patients received antibiotic therapy with 6 patients receiving concomitant steroid agents. Commonly prescribed therapies were an aminoglycoside in 33%, chloramphenicol in 15% and a combination of aminoglycoside and cephalosporin in 12.6% of individuals. Of 662 cases with corneal scrape information, 206 were culture positive. This comprised of 16.5% gram positive bacteria, 70.9% gram negative bacteria, 5.8% fungal elements, 2.9% acanthamoeba and 4% polymicrobial growth. Pseudomonas aeruginosa, was most commonly isolated in 140 specimens. Empirical therapy with an aminoglycoside and cephalosporin was initiated in 45% of cases. Fluoroquinolones were used as monotherapy in 20% of cases, while 12% of patients received combination cephalosporin and fluoroquinolone therapy this form of treatment. 7.4% of patients received a combination of aminogylcosides and fluoroquinolone. 16 patients received antifungal treatment while 29 patients received treatment for Acanthamoeba. Antivirals were prescribed for 3 patients

Conclusions : This study reports the largest case series of contact lens related corneal infections in Asia. Pseudomonas aeruginosa was the most commonly recovered organism. Number of positive fungal cultures were surprisingly low. Aminoglycoside and chloramphenicol monotherapy appeared to be the most commonly prescribed treatment in the community. Aminoglycoside and cephalosporin empirical combination therapy was frequently administered in institutions

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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