Predictors of Post-treatment Visual Improvement After Bacterial Keratitis Infection at a Referral Center in Southern California.

IF 2.1 3区医学 Q2 OPHTHALMOLOGY

Cornea Pub Date : 2025-09-08 DOI:10.1097/ICO.0000000000003983

Onyinye Onyia, Elise L Ma, Kishan Gupta, Omai B Garner, Sophie X Deng, Simon S M Fung

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引用次数: 0

Abstract

Purpose: To evaluate visual outcomes after bacterial keratitis (BK) and identify predictive factors for poor prognosis at a tertiary referral center in Southern California.

Methods: This is a cross-sectional retrospective review of patients' medical records with culture-positive BK at University of California Los Angeles from January 1, 2014, to December 31, 2019. Main outcome measure was change in best-corrected visual acuity (BCVA) at 12 weeks posttreatment. Statistical analyses included ANOVA for independent populations, Pearson correlation, and binary logistic regression. P-value <0.05 was considered significant.

Results: A total of 317 patients with 374 culture-positive cases were identified. Mean age was 62.1 ± 19.9 years, 52% were female, and 68.1% of isolates were Gram-positive. A total of 114 cases occurred during the summer months (June-August), and 29.8% had a history of contact lens wear, trauma, or systemic disease. Median symptom-to-presentation time was 3.5 days (range 1-60). Mean BCVA improved from 1.84 ± 0.91 at presentation to 1.40 ± 0.96 log of the minimum angle of resolution at 12 weeks (mean difference = 0.44, 95% confidence interval, 0.34-0.53; P < 0.001). Increasing age correlated negatively with change in BCVA (Pearson β = -0.167, P < 0.008). Multivariate analysis identified age >60 years, presence of systemic comorbidities, and presenting BCVA >1.00 log of the minimum angle of resolution as predictors of poor visual outcome.

Conclusions: This study provides the largest contemporary analysis of BK in Southern California and establishes a clinically applicable risk stratification model. Older age, systemic comorbidities, and poor presenting vision were independently associated with worse visual outcomes. These findings support earlier identification of high-risk patients, tailored treatment strategies to improve visual prognosis and optimize care delivery in BK.

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南加州转诊中心细菌性角膜炎感染治疗后视力改善的预测因素。

目的：评估细菌性角膜炎（BK）后的视力结果，并确定南加州三级转诊中心预后不良的预测因素。方法：对2014年1月1日至2019年12月31日加州大学洛杉矶分校培养阳性BK患者的病历进行横断面回顾性分析。主要观察指标为治疗后12周最佳矫正视力（BCVA）的变化。统计分析包括独立人群的方差分析、Pearson相关和二元逻辑回归。p值结果：共发现317例患者，其中培养阳性病例374例。平均年龄62.1±19.9岁，女性52%，革兰氏阳性68.1%。114例病例发生在夏季（6 - 8月），29.8%有隐形眼镜佩戴史、外伤史或全身性疾病史。从症状到出现的中位时间为3.5天（范围1-60天）。平均BCVA从首发时的1.84±0.91改善到12周时最小分辨角的1.40±0.96 log（平均差异= 0.44,95%可信区间为0.34-0.53;P < 0.001）。年龄增加与BCVA变化呈负相关（Pearson β = -0.167, P < 0.008）。多变量分析确定年龄bbb60岁，存在系统性合并症，BCVA >1.00 log最小分辨角作为视力不良的预测因素。结论：本研究提供了南加州当代最大规模的BK分析，并建立了临床适用的风险分层模型。年龄较大、全身性合并症和呈现视力差与较差的视力结果独立相关。这些发现支持早期识别高危患者，定制治疗策略，以改善视力预后和优化BK的护理提供。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cornea 医学-眼科学

CiteScore

5.20

自引率

10.70%

发文量

354

审稿时长

3-6 weeks

期刊介绍： For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.