Clinical analysis of 196 infectious keratitis in Jingzhou Region

Abstract

Objective To investigate the general features,epidemiology and sequelae of 196 infectious keratitis in Jingzhou Region,and to provide proper evidences for blindness prevention.Methods Retrospective review of the general features,predisposing factors,laboratory examination and treatment effectiveness were collected and analyzed in 196 patients with confirmed infectious keratitis in our hospital from January 2010 to December 2012.Results Among the 196 patients (198eyes),118 (120 eyes) were male and 78 (78 eyes) were female with mean age at 58.6 years.The age distribution was mainly 41-60 years old.The important risk factors were corneal trauma,ocular surface disease,contact lens wear,steroid use and previous ocular surgery.The leading infectious keratitis was fungal keratitis (128 patients,128 eyes,63.5％) and followed by viral keratitis (47 patients,49 eyes,30.0％).Twenty-one patients (21 eyes,10.7％) were confirmed with bacterial keratitis.The positive rate of direct microscopic examination of corneal scraping was 67.2％ in fungal keratitis.In 123 cultured specimens,46 cases (37.4％) were detected positive,8 showed bacterial growth,and 38 demonstrated fungal growth.The median time from inciting event to receiving treatment in our hospital was 32±7.4d.Sixty eyes received operation.Among them,26 eyes undertook local debridement with conjunctival flap covering,12 eyes received local debridement with amniotic membrane transplantation and conjunctival flap covering,8 patients went to higher hospital for keratoplasty,and 17 eyes received enucleation finally.Conclusions Fungal keretitis is the major cause of corneal infections and is followed by viral keratitis in Jingzhou Central Hospital.An incremental increase is seen in the number of fungal keratitis cases and bacterial keratitis show a decline during the study period.This disconcerting trend and the fairly high rate of blindness resulting in infectious keratitis warrant further research.Patients with infectious keratitis have generally poor visual outcomes and accepted treatment promptly may improve the outcome.Local debridement with conjunctival flap covering and/or amniotic membrane transplantation is a method reserved to be recommended when drug treatment is unhelpful. Key words: Infectious keratitis; Epidemiology; Clinical analysis; Blindness prevention