Binh Cao, Vishnu Teja Gonugunta, Naveen Radhakrishnan, Prajna Lalitha, Bharat Gurnani, Kirandeep Kaur, Geetha Iyer, Shweta Agarwal, Bhaskar Srinivasan, Jeremy D Keenan, N Venkatesh Prajna
{"title":"角膜炎的预后:个体患者数据的荟萃分析。","authors":"Binh Cao, Vishnu Teja Gonugunta, Naveen Radhakrishnan, Prajna Lalitha, Bharat Gurnani, Kirandeep Kaur, Geetha Iyer, Shweta Agarwal, Bhaskar Srinivasan, Jeremy D Keenan, N Venkatesh Prajna","doi":"10.1007/s40135-022-00302-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pythium keratitis is a difficult-to-treat corneal infection.</p><p><strong>Methods: </strong>A meta-analysis of individual patient data from observational studies of Pythium keratitis was performed. The outcomes of interest were therapeutic penetrating keratoplasty (TPK) and globe removal (evisceration, enucleation, or exenteration); the main exposures were linezolid and azithromycin use.</p><p><strong>Findings: </strong>Of 46 eligible articles, individual patient data were available for 306 eyes (34 studies). Pythium keratitis was associated with high rates of TPK (80%, 95%CI 70-87%) and globe removal (25%, 95%CI 13-43). In multivariable models adjusting for age and country, fewer TPKs were performed in patients treated with azithromycin (RR=0.80, 95%CI 0.67-0.96; <i>P</i>=0.04) and linezolid (RR=0.82, 95%CI 0.67-0.99; <i>P</i>=0.02).</p><p><strong>Conclusions: </strong>Studies of Pythium keratitis reported high rates of TPK and globe removal. Use of azithromycin and linezolid was associated with a lower rate of TPK. While promising, these results should be interpreted with caution given the biases inherent to observational studies.</p>","PeriodicalId":10836,"journal":{"name":"Current Ophthalmology Reports","volume":null,"pages":null},"PeriodicalIF":0.9000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10211475/pdf/","citationCount":"1","resultStr":"{\"title\":\"Outcomes of Pythium keratitis: a meta-analysis of individual patient data.\",\"authors\":\"Binh Cao, Vishnu Teja Gonugunta, Naveen Radhakrishnan, Prajna Lalitha, Bharat Gurnani, Kirandeep Kaur, Geetha Iyer, Shweta Agarwal, Bhaskar Srinivasan, Jeremy D Keenan, N Venkatesh Prajna\",\"doi\":\"10.1007/s40135-022-00302-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pythium keratitis is a difficult-to-treat corneal infection.</p><p><strong>Methods: </strong>A meta-analysis of individual patient data from observational studies of Pythium keratitis was performed. The outcomes of interest were therapeutic penetrating keratoplasty (TPK) and globe removal (evisceration, enucleation, or exenteration); the main exposures were linezolid and azithromycin use.</p><p><strong>Findings: </strong>Of 46 eligible articles, individual patient data were available for 306 eyes (34 studies). Pythium keratitis was associated with high rates of TPK (80%, 95%CI 70-87%) and globe removal (25%, 95%CI 13-43). In multivariable models adjusting for age and country, fewer TPKs were performed in patients treated with azithromycin (RR=0.80, 95%CI 0.67-0.96; <i>P</i>=0.04) and linezolid (RR=0.82, 95%CI 0.67-0.99; <i>P</i>=0.02).</p><p><strong>Conclusions: </strong>Studies of Pythium keratitis reported high rates of TPK and globe removal. Use of azithromycin and linezolid was associated with a lower rate of TPK. While promising, these results should be interpreted with caution given the biases inherent to observational studies.</p>\",\"PeriodicalId\":10836,\"journal\":{\"name\":\"Current Ophthalmology Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2022-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10211475/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Ophthalmology Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s40135-022-00302-7\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/11/10 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Ophthalmology Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s40135-022-00302-7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/11/10 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Outcomes of Pythium keratitis: a meta-analysis of individual patient data.
Background: Pythium keratitis is a difficult-to-treat corneal infection.
Methods: A meta-analysis of individual patient data from observational studies of Pythium keratitis was performed. The outcomes of interest were therapeutic penetrating keratoplasty (TPK) and globe removal (evisceration, enucleation, or exenteration); the main exposures were linezolid and azithromycin use.
Findings: Of 46 eligible articles, individual patient data were available for 306 eyes (34 studies). Pythium keratitis was associated with high rates of TPK (80%, 95%CI 70-87%) and globe removal (25%, 95%CI 13-43). In multivariable models adjusting for age and country, fewer TPKs were performed in patients treated with azithromycin (RR=0.80, 95%CI 0.67-0.96; P=0.04) and linezolid (RR=0.82, 95%CI 0.67-0.99; P=0.02).
Conclusions: Studies of Pythium keratitis reported high rates of TPK and globe removal. Use of azithromycin and linezolid was associated with a lower rate of TPK. While promising, these results should be interpreted with caution given the biases inherent to observational studies.
期刊介绍:
This journal aims to offer expert review articles on the most significant recent developments in the field of ophthalmology. By providing clear, insightful, balanced contributions, the journal intends to serve those who diagnose, treat, manage, and prevent ocular conditions and diseases. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An Editorial Board of more than 20 internationally diverse members reviews the annual table of contents, ensures that topics include emerging research, and suggests topics of special importance to their country/region. Topics covered may include age-related macular degeneration; diabetic retinopathy; dry eye syndrome; glaucoma; pediatric ophthalmology; ocular infections; refractive surgery; and stem cell therapy.