Document Detail


Predictors of outcome in fungal keratitis.
MedLine Citation:
PMID:  22744392     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To analyse predictors of clinical outcome in fungal keratitis.
METHODS: Data was collected during a prospective, randomized, controlled, double-masked clinical trial of treatment for fungal keratitis. Clinical features at presentation and demographics were collected at the enrollment visit for all patients. Pre-specified clinical outcomes included 3-month visual acuity and infiltrate/scar size, time to re-epithelialization, and corneal perforation. A separate multivariable model with each outcome as the dependent variable included all predictor variables.
RESULTS: Predictors for worse 3-month visual acuity include older age (P=0.024), worse presentation visual acuity (P<0.001), larger infiltrate size at presentation (P<0.001), and pigmented ulcer (P=0.030). Larger infiltrate size at presentation was a significant predictor of worse 3-month infiltrate/scar size (P<0.001). Larger epithelial defect size was a significant predictor of perforation (P=0.0013). Predictors of longer time to re-epithelialization include infiltrate size at presentation (P<0.001) and older age (P=0.025).
CONCLUSION: Ulcer severity at presentation is highly predictive of worse outcomes. Presentation of clinical characteristics such as baseline acuity and infiltrate scar can provide important information to clinicians about prognosis, and may help guide management and treatment decisions. Prevention of corneal ulcer remains important, as it is difficult to change the course of the ulcer once it has begun.
Authors:
N Venkatesh Prajna; T Krishnan; J Mascarenhas; M Srinivasan; C E Oldenburg; C M Toutain-Kidd; A Sy; S D McLeod; M E Zegans; N R Acharya; T M Lietman; T C Porco
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2012-06-29
Journal Detail:
Title:  Eye (London, England)     Volume:  26     ISSN:  1476-5454     ISO Abbreviation:  Eye (Lond)     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-17     Completed Date:  2013-01-17     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  8703986     Medline TA:  Eye (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  1226-31     Citation Subset:  IM    
Affiliation:
Aravind Eye Care System, Madurai, India.
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MeSH Terms
Descriptor/Qualifier:
Administration, Topical
Antifungal Agents / therapeutic use
Corneal Perforation / diagnosis
Corneal Ulcer / diagnosis*,  drug therapy,  microbiology
Debridement
Double-Blind Method
Eye Infections, Fungal / diagnosis*,  drug therapy,  microbiology
Female
Humans
Male
Natamycin / therapeutic use
Ophthalmic Solutions
Outcome and Process Assessment (Health Care)
Prognosis
Prospective Studies
Pyrimidines / therapeutic use
Re-Epithelialization
Risk Factors
Time Factors
Triazoles / therapeutic use
Visual Acuity / physiology
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Ophthalmic Solutions; 0/Pyrimidines; 0/Triazoles; 0/voriconazole; 7681-93-8/Natamycin
Comments/Corrections

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