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Article . 2012 . Peer-reviewed
License: Springer TDM
Data sources: Crossref
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Predictors of outcome in fungal keratitis

Authors: Prajna, N Venkatesh; Krishnan, T; Mascarenhas, J; Srinivasan, M; Oldenburg, CE; Toutain-Kidd, CM; Sy, A; +5 Authors

Predictors of outcome in fungal keratitis

Abstract

To analyse predictors of clinical outcome in fungal keratitis.Data was collected during a prospective, randomized, controlled, double-masked clinical trial of treatment for fungal keratitis. Clinical features at presentation and demographics were collected at the enrollment visit for all patients. Pre-specified clinical outcomes included 3-month visual acuity and infiltrate/scar size, time to re-epithelialization, and corneal perforation. A separate multivariable model with each outcome as the dependent variable included all predictor variables.Predictors for worse 3-month visual acuity include older age (P=0.024), worse presentation visual acuity (P<0.001), larger infiltrate size at presentation (P<0.001), and pigmented ulcer (P=0.030). Larger infiltrate size at presentation was a significant predictor of worse 3-month infiltrate/scar size (P<0.001). Larger epithelial defect size was a significant predictor of perforation (P=0.0013). Predictors of longer time to re-epithelialization include infiltrate size at presentation (P<0.001) and older age (P=0.025).Ulcer severity at presentation is highly predictive of worse outcomes. Presentation of clinical characteristics such as baseline acuity and infiltrate scar can provide important information to clinicians about prognosis, and may help guide management and treatment decisions. Prevention of corneal ulcer remains important, as it is difficult to change the course of the ulcer once it has begun.

Country
United States
Related Organizations
Keywords

Male, Antifungal Agents, Time Factors, Natamycin, Administration, Topical, Eye Infections, Clinical Sciences, Immunology, Visual Acuity, Outcome and Process Assessment, Eye, Ophthalmology & Optometry, Double-Blind Method, Re-Epithelialization, Clinical Research, Opthalmology and Optometry, Risk Factors, risk factors, Humans, Prospective Studies, Corneal Ulcer, Eye Disease and Disorders of Vision, Corneal Perforation, fungus, Triazoles, Prognosis, Health Care, Fungal, keratitis, Outcome and Process Assessment, Health Care, Pyrimidines, Topical, Debridement, Administration, Female, Voriconazole, Ophthalmic Solutions, Eye Infections, Fungal

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    selected citations
    These citations are derived from selected sources.
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    70
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
70
Top 10%
Top 10%
Top 10%
Green
bronze