Jules Stein Eye Institute, University of California, Los Angeles, 90095, USA.
Am J Ophthalmol. 2011 Oct;152(4):575-581.e1. doi: 10.1016/j.ajo.2011.03.014. Epub 2011 Jun 17.
To determine the incidence, risk factor, and outcomes of elevated intraocular pressure (IOP) during active microbial keratitis.
Retrospective cohort study.
One hundred eighty-four patients with culture-proven microbial keratitis examined from January 2003 through December 2007 were included. High IOP was defined as IOP of 22 mm Hg or higher measured during the episode of active keratitis. The control group consisted of eyes with microbial keratitis whose IOP remained less than 22 mm Hg. Twelve factors were evaluated by univariate and multivariate analyses to determine whether any were associated with increased IOP. The incidence, risk factors, microbial profile, the necessity of therapeutic surgery, time to resolution, and final visual acuity were compared between the high IOP group and the control group.
High IOP (mean, 29.1 mm Hg; range, 22 to 51 mm Hg) occurred in 52 (28%) of 184 patients with active corneal infection. Prior ocular surgery, diabetes mellitus, and ulcer size of 4.0 mm or larger were associated with IOP elevation (P ≤ .013). Surgical interventions were necessary in 19 (39%) of 49 patients in the high IOP group and in 14 (11%) of 129 patients in the control group (P < .0001). Time to ulcer resolution was longer in the high IOP group (mean, 50.1 ± 53.2 days) than in the control (mean, 31.6 ± 42.0 days; P = .005). Final visual acuity of 20/40 or better was achieved by more patients in the control group (47%) than in the high IOP group (20%; P < .001).
Elevated IOP was detected in a significant proportion of patients with active microbial keratitis and was associated with poorer outcomes. Routine IOP check should be performed to avoid possible optic nerve damage.
确定活动期微生物角膜炎患者眼压升高的发生率、危险因素和结局。
回顾性队列研究。
纳入 2003 年 1 月至 2007 年 12 月期间经培养证实的微生物角膜炎患者 184 例。高眼压定义为活动期角膜炎发作时眼压高于 22mmHg。对照组由微生物角膜炎患者组成，其眼压低于 22mmHg。通过单因素和多因素分析评估 12 个因素，以确定是否有任何因素与眼压升高相关。比较高眼压组和对照组的发生率、危险因素、微生物谱、是否需要治疗性手术、缓解时间和最终视力。
在 184 例活动性角膜感染患者中，52 例（28%）发生高眼压（平均眼压 29.1mmHg；范围 22-51mmHg）。既往眼部手术、糖尿病和溃疡直径 4.0mm 或更大与眼压升高相关（P≤0.013）。高眼压组 49 例患者中有 19 例（39%）和对照组 129 例患者中有 14 例（11%）需要手术干预（P<0.0001）。高眼压组溃疡愈合时间较长（平均 50.1±53.2 天），对照组（平均 31.6±42.0 天；P=0.005）。对照组视力达到 20/40 或更好的患者比例（47%）高于高眼压组（20%；P<0.001）。
在活动性微生物角膜炎患者中，相当一部分患者眼压升高，且与较差的结局相关。应常规检查眼压，以避免可能的视神经损伤。
