Ballouz Dena, Niziol Leslie M, Prajna N Venkatesh, Farsiu Sina, Shtein Roni M, Verkade Angela, Miller Keith D, Sherman Eric, Pawar Mercy, Selvaraj Suvitha, Kuppuraj Dhanya, Kochar Prabhleen, Thibodeau Alexa, Enright Jennifer, Woodward Maria A
Department of Ophthalmology and Visual Sciences (D.B., L.M.N., R.M.S., A.V., K.D.M., E.S., M.P., A.T., J.E., M.A.W.), University of Michigan, Ann Arbor, MI; Aravind Eye Care System (N.V.P., S.S., D.K., P.K.), Madurai, Tamil Nadu, India; Department of Biomedical Engineering (S.F.), Duke University, Durham, NC; and Institute for Healthcare Policy and Innovation (M.A.W.), University of Michigan, Ann Arbor, MI.
Eye Contact Lens. 2025 Jun 19;51(8):336-342. doi: 10.1097/ICL.0000000000001200.
Microbial keratitis (MK) is a vision-threatening and often painful corneal infection. This study aims to quantify severity of symptoms of MK at presentation and investigate their association with visual acuity (VA).
The Automated Quantitative Ulcer Analysis (AQUA) study recruited MK patients from two sites (University of Michigan and Aravind Eye Care System). At presentation, best-corrected VA was recorded. Patients were surveyed on severity of symptoms on a five-point scale for pain or a four-point scale for redness, light sensitivity/glare, and blurry vision. The association between symptom severity and VA was tested with Spearman correlations (r) and Kruskal-Wallis tests.
Seven hundred three patients with MK were enrolled in the AQUA study from July 2020 to November 2022. Presenting logMAR VA had a median value of 1.3 (Snellen equivalent, 20/400). Most patients reported pain (98.7%), redness (99.1%), light sensitivity/glare (98.4%), and blurry vision (99.2%). Visual acuity showed a significant correlation with cumulative symptom severity (spearman r=0.15, P <0.0001). For those who reported pain and blurry vision, VA worsened with increasing symptom severity ( P <0.0001).
Presenting VA showed a significant positive correlation with cumulative symptom severity and the individual symptoms of pain and blurry vision. Patient-reported symptoms at MK presentation may indicate disease severity.
微生物性角膜炎（MK）是一种威胁视力且常伴有疼痛的角膜感染。本研究旨在量化MK患者就诊时症状的严重程度，并调查其与视力（VA）的关系。
自动定量溃疡分析（AQUA）研究从两个地点（密歇根大学和阿拉文德眼科护理系统）招募MK患者。就诊时，记录最佳矫正视力。对患者进行症状严重程度调查，疼痛采用五点量表，眼红、畏光/眩光和视物模糊采用四点量表。采用Spearman相关性分析（r）和Kruskal-Wallis检验来测试症状严重程度与视力之间的关联。
2020年7月至2022年11月，共有703例MK患者纳入AQUA研究。就诊时的logMAR视力中位数为1.3（Snellen等效值，20/400）。大多数患者报告有疼痛（98.7%）、眼红（99.1%）、畏光/眩光（98.4%）和视物模糊（99.2%）。视力与累积症状严重程度呈显著相关性（Spearman r = 0.15，P < 0.0001）。对于报告有疼痛和视物模糊的患者，随着症状严重程度的增加，视力恶化（P < 0.0001）。
就诊时的视力与累积症状严重程度以及疼痛和视物模糊的个体症状呈显著正相关。MK患者就诊时自我报告的症状可能表明疾病的严重程度。
