Sakiyalak Darin, Chattagoon Yuwared
Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,
Clin Ophthalmol. 2018 Oct 24;12:2121-2128. doi: 10.2147/OPTH.S169280. eCollection 2018.
The aim of this study was to investigate the incidence of and risk factors for secondary ocular hypertension (OHT) in patients with moderate to severe infectious ulcerative keratitis and to evaluate the long-term outcome of patients with secondary OHT.
A retrospective chart review of 346 patients with moderate to severe infectious keratitis admitted to Siriraj Hospital during the period from 1 January 2005 to 31 May 2008 was conducted. Secondary OHT was defined as intraocular pressure (IOP) greater than 21 mmHg or a consistent demonstration of higher IOP in the affected eye of 8 mmHg or greater, at any time before resolution of the ulcer. The incidence of and the risk factors for secondary OHT were determined. Among the patients with secondary OHT, the incidence of and the risk factors for persistent elevated IOP and blindness at the last follow-up were also evaluated.
Two hundred and two eyes were included in the study. The incidence of secondary OHT was 45.5%. Severe keratitis and severe anterior chamber cells' reaction were the risk factors for IOP elevation during active keratitis (=0.003 and 0.018, respectively). Long-term data were available for 69 patients with OHT; 32.9% (22/69) developed persistent IOP elevation after keratitis resolved. Older age (=0.007) and hyperosmotic agents used during active keratitis (=0.028) were associated with persistent IOP elevation. Age was also associated with blindness among the patients with secondary OHT (=0.002).
Moderate to severe infectious keratitis was associated with a high incidence of secondary OHT. Two main risk factors were severe corneal infiltration and severe intraocular inflammation. One-third of the patients with OHT developed persistent elevated IOP after keratitis was healed. Older age and hyperosmotic agents used during active keratitis were significantly associated with persistent elevated IOP. Older age was also associated with poorer visual outcome.
本研究旨在调查中重度感染性溃疡性角膜炎患者继发性高眼压（OHT）的发生率及危险因素，并评估继发性OHT患者的长期预后。
对2005年1月1日至2008年5月31日期间入住诗里拉吉医院的346例中重度感染性角膜炎患者进行回顾性病历审查。继发性OHT定义为在溃疡愈合前的任何时间，眼压（IOP）大于21 mmHg，或患眼IOP持续升高8 mmHg或更高。确定继发性OHT的发生率及危险因素。在继发性OHT患者中，还评估了最后一次随访时IOP持续升高和失明的发生率及危险因素。
202只眼纳入研究。继发性OHT的发生率为45.5%。严重角膜炎和严重前房细胞反应是活动性角膜炎期间IOP升高的危险因素（分别为=0.003和0.018）。69例OHT患者有长期数据；32.9%（22/69）在角膜炎消退后出现IOP持续升高。年龄较大（=0.007）和活动性角膜炎期间使用高渗剂（=0.028）与IOP持续升高有关。年龄也是继发性OHT患者失明的相关因素（=0.002）。
中重度感染性角膜炎与继发性OHT的高发生率相关。两个主要危险因素是严重角膜浸润和严重眼内炎症。三分之一的OHT患者在角膜炎愈合后出现IOP持续升高。年龄较大和活动性角膜炎期间使用高渗剂与IOP持续升高显著相关。年龄较大也与较差的视力预后相关。
