Lavinsky Fabio, Avni-Zauberman Noah, Barequet Irina S
Goldschleger Eye Institute, Sheba Medical Center, Tel Aviv University Sackler, Faculty of Medicine, Tel Hashomer, Israel.
Arq Bras Oftalmol. 2013 May-Jun;76(3):175-9. doi: 10.1590/s0004-27492013000300009.
Microbial keratitis is commonly diagnosed worldwide, and continues to cause significant ocular morbidity, requiring prompt and appropriate treatment. The objective of this study is to describe the clinical characteristics and outcomes of patients with presumed microbial keratitis admitted to The Goldschleger Eye Institute, Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel.
A cross-sectional study was conducted, in which the medical records of patients with presumed microbial keratitis admitted during a period of 3 years were reviewed.
Keratitis was diagnosed in 276 patients (51% males and 48.9% females). The mean age was 39.29 ± 22.30 years. The hospital length of stay ranged from 1 to 65 days (mean 5.69 ± 5.508). Fortified antibiotics were still used at discharge in 72% of the cases. Overall visual acuity improved significantly from the time of admission to the 1st-week follow up visit showing a p<0.001 on the Wilcoxon signed ranks test. Contact lens wearing was present in 36.1% of the patients, although there was no significant relation with severity of the presentation and visual outcome (p>0.05). The degree of hypopyon and cells in the anterior chamber was significantly related to the hospital length of stay (r Spearman=0.31; p<0.001 and r Spearman=0.21; p<.001, respectively) as well as to a worse visual outcome (r Spearman=0.32; p<0.01 and r Spearman=0.18; p=0.01, respectively). Of all patients, 2.3% required an urgent therapeutic penetrating keratoplasty, and 1% underwent evisceration. There was no enucleation.
Treating keratitis aggressively and assuring patient compliance is imperative for a good final visual outcome. Inpatient treatment may have a positive impact on this outcome.
微生物性角膜炎在全球范围内普遍被诊断出来，并且持续导致严重的眼部疾病，需要及时且恰当的治疗。本研究的目的是描述以色列特拉维夫大学谢巴医疗中心戈德施莱格眼科研究所收治的疑似微生物性角膜炎患者的临床特征及治疗结果。
开展了一项横断面研究，回顾了3年间收治的疑似微生物性角膜炎患者的病历。
共诊断出276例角膜炎患者（男性占51%，女性占48.9%）。平均年龄为39.29±22.30岁。住院时间为1至65天（平均5.69±5.508天）。72%的病例在出院时仍使用强化抗生素。总体视力从入院时到第1周随访时有显著改善，Wilcoxon符号秩检验显示p<0.001。36.1%的患者佩戴隐形眼镜，尽管其与病情严重程度及视力预后无显著相关性（p>0.05）。前房积脓程度和前房细胞数量与住院时间显著相关（Spearman相关系数r分别为0.31；p<0.001和0.21；p<0.001），也与较差的视力预后相关（Spearman相关系数r分别为0.32；p<0.01和0.18；p=0.01）。所有患者中，2.3%需要紧急治疗性穿透性角膜移植术，1%接受了眼球内容剜除术。无眼球摘除术病例。
积极治疗角膜炎并确保患者依从性对于良好的最终视力预后至关重要。住院治疗可能对此结果产生积极影响。
