Visual Outcomes in Treated Bacterial Keratitis: Four Years of Prospective Follow-up
Visual Outcomes in Treated Bacterial Keratitis: Four Years of Prospective Follow-up
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DOI：
10.1167/iovs.14-13980
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发表时间：
2014-05-01
影响因子：
4.4
通讯作者：
Keenan, Jeremy D.
中科院分区：
文献类型：
--
作者：
McClintic, Scott M.;Prajna, Namperumalsamy V.;Keenan, Jeremy D.
目的.我们描述了成功治疗细菌性角膜炎的眼睛所经历的视力变化。这是一项前瞻性队列研究，研究对象为之前参加过类固醇治疗角膜溃疡试验（SCUT）的研究参与者子集。所有研究参与者在入选SCUT之前均被诊断为培养证实的细菌性角膜炎，随后被随机分配接受局部皮质类固醇或安慰剂治疗。在SCUT期间，我们在入组、3周、3个月和12个月时监测研究参与者。我们邀请了一个子集完成全面的眼科检查后约4年，在华南理工大学入学。在每次研究访视时，由经认证的验光师使用相同的方案评估最佳屈光矫正视力（BSCVA）。我们在入学后4年检查了50名SCUT参与者。在该队列中，入组时的平均logMAR BSCVA为0.85（Snellen等效值，20/160; 95%置信区间[CI]，0.71-0.99）。从入组至3周，视力平均提高2.9 logMAR行（P < 0.001），从3周至3个月，视力平均提高1.2行（P = 0.002），从3至12个月，视力平均提高0.8行（P = 0.01）。BSCVA在12个月和4年之间没有显著变化（0.04线改善，P = 0.88）。在控制入组时的视力后，4年时皮质类固醇组和安慰剂组的BSCVA无显著差异（P = 0.53）。细菌性角膜炎的病例在诊断后12个月内可能会继续表现出视力的改善，但进一步改善的可能性不大。这些发现可以指导这些患者手术干预的适当时机。
PURPOSE. We described the change in visual acuity experienced by eyes successfully treated for bacterial keratitis.METHODS. This was a prospective cohort study of a subset of study participants who had previously enrolled in the Steroids for Corneal Ulcers Trial (SCUT). All study participants had been diagnosed with culture-proven bacterial keratitis before enrollment in SCUT and subsequently were randomized to adjunctive topical corticosteroids or placebo. During SCUT, we monitored study participants at enrollment, 3 weeks, 3 months, and 12 months. We invited a subset to complete a comprehensive eye examination approximately 4 years after enrollment in SCUT. Certified refractionists assessed best spectacle-corrected visual acuity (BSCVA) using the same protocol at each study visit.RESULTS. We examined 50 SCUT participants at 4 years after enrollment. Among those in this cohort, mean logMAR BSCVA at enrollment was 0.85 (Snellen equivalent, 20/160; 95% confidence interval [CI], 0.71-0.99). On average, visual acuity improved by 2.9 logMAR lines from enrollment to 3 weeks (P < 0.001), 1.2 lines from 3 weeks to 3 months (P = 0.002), and 0.8 lines from 3 to 12 months (P = 0.01). The BSCVA did not change significantly between 12 months and 4 years (0.04-line improvement, P = 0.88). After controlling for visual acuity at enrollment, BSCVA was not significantly different between the corticosteroid and placebo groups at 4 years (P = 0.53).CONCLUSIONS. Cases of bacterial keratitis may continue to demonstrate improvements in visual acuity up to 12 months following diagnosis, but further improvements are unlikely. These findings may guide the appropriate timing of surgical intervention in these patients.