Document Detail


Classifying the severity of corneal ulcers by using the "1, 2, 3" rule.
MedLine Citation:
PMID:  17198008     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To propose and define the "1, 2, 3" rule as a system of categorizing the severity of bacterial keratitis and to determine its value in predicting the likelihood of visual loss after healing of bacterial corneal infection. METHODS: Seventy patients were evaluated for infectious corneal ulcers by 2 cornea subspecialists (J.D.L., M.C.V.) at a tertiary facility between October 30, 2001, and November 1, 2004. Forty-one patients met the inclusion criteria. Visual acuities, ulcer characteristics, culture results, and treatment data were collected. RESULTS: The sensitivity of the "1, 2, 3" rule for detecting potentially sight-threatening (PST) ulcers that would result in 0.20 logMAR (2 Snellen lines) or greater loss in best spectacle-corrected visual acuity (BSCVA) was 100%. The specificity of the "1, 2, 3" rule in correctly labeling an ulcer that did not cause vision loss as rarely sight threatening (RST) was 57.14%. The positive predictive value of the "1, 2, 3" rule was 28.57%. The negative predictive value of the "1, 2, 3" rule was 100%. CONCLUSIONS: Corneal ulcers classified as PST are at significantly higher risk for sustaining loss of BCSVA compared with RST corneal ulcers. The "1, 2, 3" rule is sensitive and specific enough to be clinically useful in predicting which ulcers are more likely to have vision loss and which ulcers are not.
Authors:
Mark C Vital; Marcel Belloso; Thomas C Prager; Jeffrey D Lanier
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cornea     Volume:  26     ISSN:  0277-3740     ISO Abbreviation:  Cornea     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-01     Completed Date:  2007-02-20     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  8216186     Medline TA:  Cornea     Country:  United States    
Other Details:
Languages:  eng     Pagination:  16-20     Citation Subset:  IM    
Affiliation:
Houston Eye Associates, Houston, TX, USA. mceyemd@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents / therapeutic use
Corneal Ulcer / classification*,  drug therapy,  microbiology*
Diagnostic Techniques, Ophthalmological*
Eye Infections, Bacterial / classification*,  drug therapy,  microbiology
False Positive Reactions
Female
Humans
Likelihood Functions
Male
Middle Aged
Predictive Value of Tests
Risk Factors
Sensitivity and Specificity
Severity of Illness Index
Vancomycin / therapeutic use
Vision Disorders / etiology
Wound Healing
Grant Support
ID/Acronym/Agency:
EY10608/EY/NEI NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 1404-90-6/Vancomycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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