Alwohaibi Nada N, Bamashmoos Malak, Al Somali Abdulaziz
Ophthalmology Department, King Fahad Hospital of the University, Khobar, Eastern Province, Kingdom of Saudi Arabia.
Ophthalmology, Dhahran Eye Specialist Hospital, Dammam, Saudi Arabia.
Clin Ophthalmol. 2022 Mar 15;16:775-783. doi: 10.2147/OPTH.S323408. eCollection 2022.
To describe the predisposing factors, causative organisms, treatment modalities, and visual outcomes of childhood non-viral microbial keratitis in our region.
All cases with the clinical or microbiological diagnosis of non-viral microbial keratitis in patients ≤18 years presenting to Dhahran Eye specialist Hospital, a tertiary eye care hospital in Dhahran, Eastern Province, Saudi Arabia, between 2010 and 2020 were included. A retrospective chart review was conducted. Demographic data, predisposing factors, clinical characteristics, isolated microorganisms, and visual outcomes were recorded.
Fifty-nine patients were included in this study, of which three cases were bilateral. The mean age was 9.3 ± 6.3 years (range: 14 days - 18 years). Predisposing factors were identified in 89.8% (n=53) of cases. Contact lens wear was the leading cause 35.6% (n=21), followed by trauma 27.1% (n=16), ocular diseases 11.9% (n=7), systemic diseases 10.2% (n=6), and ocular surgery 5.1% (n=3). Out of all cases, 66.1% (n=39) have undergone corneal scraping, out of which 43.6% (n=17) showed positive growth. Gram-negative organisms accounted for 47.1% (n=8) isolates of all culture-positive cases. was the most common pure isolate, which accounted for 41.2% (n=7) of culture-positive cases, followed by 11.8% (n=2). The most common complication was corneal scar in 71.2% (n=42). Nineteen (32.2%) patients had poor outcome. Seven patients (11.9%) required further intervention, these included penetrating keratoplasty (n=1), deep lamellar keratoplasty (n=3), Photorefractive keratectomy (n=2), and Phototherapeutic keratectomy (n=1).
Childhood non-viral microbial keratitis is uncommon; however, it carries significant risks. Most cases were associated with preventable risk factors, with contact lens wear being the leading cause. Early detection and management are mandatory to reduce the risk of vision-threatening complications. The difficulty in assessment should not jeopardize proper evaluation and management of suspected cases.
描述我们地区儿童非病毒性微生物性角膜炎的易感因素、致病微生物、治疗方式及视力预后。
纳入2010年至2020年间在沙特阿拉伯东部省达兰市的一家三级眼科专科医院——达兰眼科专科医院就诊的所有年龄≤18岁、临床或微生物学诊断为非病毒性微生物性角膜炎的病例。进行了回顾性病历审查。记录了人口统计学数据、易感因素、临床特征、分离出的微生物及视力预后。
本研究纳入了59例患者，其中3例为双眼患病。平均年龄为9.3±6.3岁（范围：14天至18岁）。89.8%（n=53）的病例确定了易感因素。佩戴隐形眼镜是主要原因，占35.6%（n=21），其次是外伤，占27.1%（n=16），眼部疾病占11.9%（n=7），全身性疾病占10.2%（n=6），眼部手术占5.1%（n=3）。所有病例中，66.1%（n=39）进行了角膜刮片检查，其中43.6%（n=17）显示有阳性培养结果。革兰氏阴性菌占所有培养阳性病例分离菌的47.1%（n=8）。 是最常见的单一分离菌，占培养阳性病例的41.2%（n=7），其次是 占11.8%（n=2）。最常见的并发症是角膜瘢痕，占71.2%（n=42）。19例（32.2%）患者预后较差。7例（11.9%）患者需要进一步干预，其中包括穿透性角膜移植术（n=1）、深板层角膜移植术（n=3）、准分子激光角膜切削术（n=2）和光化学角膜切削术（n=1）。
儿童非病毒性微生物性角膜炎并不常见；然而，它具有重大风险。大多数病例与可预防的危险因素相关，佩戴隐形眼镜是主要原因。早期检测和管理对于降低视力威胁性并发症的风险至关重要。评估的困难不应危及对疑似病例的正确评估和管理。
