Demographic pattern, predisposing factors and management of ulcerative keratitis: evaluation of one thousand unilateral cases at a tertiary care centre
Demographic pattern, predisposing factors and management of ulcerative keratitis: evaluation of one thousand unilateral cases at a tertiary care centre
复制标题
DOI：
10.1111/j.1442-9071.2007.01417.x
复制
发表时间：
2007-01-01
影响因子：
4
通讯作者：
Kumar, Abhiyan
中科院分区：
文献类型：
--
作者：
Panda, Anita;Satpathy, Gita;Kumar, Abhiyan
目的：目的：探讨疑似微生物性溃疡性角膜炎的易感因素、特殊临床表现及治疗方法。方法：对1000例1000眼疑似微生物性角膜炎患者进行回顾性分析。信息记录患者的年龄和性别，危险因素，季节性介绍，自溃疡开始的天数，以前的治疗，临床表现，微生物检查和case management.Results：百分之五十的角膜溃疡患者的年龄在36和65岁之间，13.3%是在儿科年龄组（1个月至< 16岁）。男女比例接近1.6：1。只有11.4%的患者在溃疡开始的第一周内向作者报告。外伤占47.6%，眼表疾病占16.6%。42%的眼睛在医院就诊前仅接受局部抗生素（一种或多种），42.2%的眼睛接受局部抗生素和抗真菌药。另外8.2%的患者使用局部皮质类固醇沿着抗生素，4.6%的患者接受不明剂量的药物。只有3%的眼睛在就诊前没有接受任何治疗。仅在8.2%的眼睛中确定接触透镜使用为风险因素。48%的溃疡位于中心部位。51.7%的眼睛观察到溃疡大小为6-9 mm。单独药物治疗是有效的，在61.0%的眼睛，另外9.7%的眼睛回应旁正中睑板缝合术沿着与局部antimicroboial drugs.Conclusions：角膜溃疡是一个常见的问题，在这部分的世界。在三级转诊医院看到的溃疡出现在疾病自然史的晚期，临床上是严重的。尽管严重，但大多数眼睛可以在解剖学上保存，但几乎65%的眼睛视力< 6/120。考虑到视力丧失的严重程度，建议对公众进行关于视力丧失的潜在性以及及时和适当治疗的重要性的教育。
Purpose: To determine the predisposing factors, special clinical manifestations and the management of presumed microbial ulcerative keratitis.Methods: A retrospective study was performed in 1000 eyes of 1000 patients with presumed microbial keratitis. Information was recorded on patients' age and gender, risk factors, seasonal presentation, number of days since initiation of ulcer, prior therapy, clinical presentation, microbiological work-up and case management.Results: Fifty per cent of the patients with corneal ulcers were aged between 36 and 65 years and 13.3% were in the paediatric age group (1 month to < 16 years). The male : female ratio was almost 1.6:1. Only 11.4% of patients reported to the authors during the first week of initiation of ulcer. Trauma was the cause in 47.6% of eyes, and ocular surface diseases accounted for 16.6%. Forty-two per cent of eyes received topical antibiotics alone (either one or more) prior to hospital visit and 42.2% of eyes were on topical antibiotics and antifungals. Another 8.2% were on topical corticosteroids along with antibiotics and 4.6% were receiving some unidentified drop. Only 3% of the eyes did not receive any therapy prior to visit. Contact lens use as a risk factor could be identified only in 8.2% of eyes. Ulcers were central in location in 48%. Ulcer size 6-9 mm was observed in 51.7% of eyes. Medical therapy alone was effective in 61.0% of eyes and another 9.7% eyes responded to paramedian tarsorrhaphy along with topical antimicroboial drugs.Conclusions: Corneal ulcers are a frequent problem in this part of the world. The ulcers seen at this tertiary referral hospital present late in the natural history of the disease and are clinically severe. Despite the severity a majority of the eyes could be saved anatomically, but almost 65% of eyes were left with a visual acuity of < 6/120. Considering the high magnitude of visual loss, public education about the potential for loss of sight and the importance of timely and appropriate treatment is recommended.