Lu Chuwei, Wang Jiajia, Hong Jiaxu, Xu Jianjiang, Zhou Xujiao, Tian Lijia, Le Qihua
Department of Ophthalmology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People's Republic of China.
NHC Key Laboratory of Myopia and Related Eye Diseases, Shanghai, People's Republic of China.
Clin Ophthalmol. 2025 Sep 9;19:3295-3305. doi: 10.2147/OPTH.S545322. eCollection 2025.
To investigate the demographic characteristics, contributing risk factors, and prognostic outcomes of keratitis (AK) in Eastern China in the recent 15 years using in vivo confocal microscopy (IVCM).
This single-center, retrospective study included 145 patients (147 eyes) diagnosed with AK based on IVCM findings at the Eye & ENT Hospital of Fudan University from April 2009 to September 2024. Demographic information, clinical features at presentation, contributing risk factors (if identified), treatment strategies, and final visual outcomes were retrieved in the medical records and analyzed using descriptive statistics.
The median age of patients was 51 years old, with 98.6% of infections being unilateral. Corneal trauma (62.1%) was the leading risk factor overall, whereas contact lens wear was the independent risk factor among children and adolescents. The most common clinical features at presentation were stromal infiltrate (60.6%) and deep stromal ulcers (36.5%). Anti-AK therapy was mainly composed of polyhexamethylene biguanide (PHMB), chlorhexidine, propamidine isethionate (Brolene) and metronidazole. Surgical interventions were required in 24 eyes, with evisceration/enucleation identified as an independent predictor of poor visual prognosis.
This study provides valuable epidemiological insights into AK in Eastern China, underscoring the need for improved prevention, early diagnosis, and evidence-based treatment protocols to guide clinical management.
利用活体共聚焦显微镜（IVCM）研究中国东部地区近15年角膜溃疡（AK）的人口统计学特征、相关危险因素及预后结果。
本单中心回顾性研究纳入了2009年4月至2024年9月在复旦大学附属眼耳鼻喉科医院根据IVCM检查结果诊断为AK的145例患者（147只眼）。从病历中获取人口统计学信息、就诊时的临床特征、相关危险因素（若已确定）、治疗策略及最终视力结果，并采用描述性统计方法进行分析。
患者的中位年龄为51岁，98.6%的感染为单眼。角膜外伤（62.1%）是总体上的主要危险因素，而佩戴隐形眼镜是儿童和青少年中的独立危险因素。就诊时最常见的临床特征是基质浸润（60.6%）和深层基质溃疡（36.5%）。抗AK治疗主要由聚六亚甲基双胍（PHMB）、氯己定、依西酸丙脒（Brolene）和甲硝唑组成。24只眼需要手术干预，眼球内容剜除术/眼球摘除术被确定为视力预后不良的独立预测因素。
本研究为中国东部地区的AK提供了有价值的流行病学见解，强调需要改进预防、早期诊断及循证治疗方案以指导临床管理。
