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Title: The Asia Cornea Society Infectious Keratitis Study: A Prospective Multicenter Study of Infectious Keratitis in Asia
Authors: Wei Boon Khor
Venkatesh N. Prajna
Prashant Garg
Jodhbir S. Mehta
Lixin Xie
Zuguo Liu
Ma Dominga B. Padilla
Choun Ki Joo
Yoshitsugu Inoue
Panida Goseyarakwong
Fung Rong Hu
Kohji Nishida
Shigeru Kinoshita
Vilavun Puangsricharern
Ai Ling Tan
Roger Beuerman
Alvin Young
Namrata Sharma
Benjamin Haaland
Francis S. Mah
Elmer Y. Tu
Fiona J. Stapleton
Richard L. Abbott
Donald Tiang Hwee Tan
Duke-NUS Medical School Singapore
Dr. Rajendra Prasad Centre for Ophthalmic Sciences
National Taiwan University Hospital
University of the Philippines Manila
St. Luke's Medical Center Quezon City
Aravind Eye Care System
Kyoto Prefectural University of Medicine
University of New South Wales (UNSW) Australia
Chulalongkorn University
University of Illinois at Chicago
Yong Loo Lin School of Medicine
Prince of Wales Hospital Hong Kong
Singapore Eye Research Institute
University of California, San Francisco
L.V. Prasad Eye Institute India
Singapore General Hospital
Osaka University Faculty of Medicine
Faculty of Medicine, Siriraj Hospital, Mahidol University
Tottori University
Singapore National Eye Centre
Scripps Clinic
The Catholic University of Korea
Xiemen Eye Center
Keywords: Medicine
Issue Date: 1-Nov-2018
Citation: American Journal of Ophthalmology. Vol.195, (2018), 161-170
Abstract: © 2018 Elsevier Inc. Purpose: To survey the demographics, risk factors, microbiology, and outcomes for infectious keratitis in Asia. Design: Prospective, nonrandomized clinical study. Methods: Thirteen study centers and 30 sub-centers recruited consecutive subjects over 12-18 months, and performed standardized data collection. A microbiological protocol standardized the processing and reporting of all isolates. Treatment of the infectious keratitis was decided by the managing ophthalmologist. Subjects were observed for up to 6 months. Main outcome measures were final visual acuity and the need for surgery during infection. Results: A total of 6626 eyes of 6563 subjects were studied. The majority of subjects were male (n = 3992). Trauma (n = 2279, 34.7%) and contact lens wear (n = 704, 10.7%) were the commonest risk factors. Overall, bacterial keratitis was diagnosed in 2521 eyes (38.0%) and fungal keratitis in 2166 eyes (32.7%). Of the 2831 microorganisms isolated, the most common were Fusarium species (n = 518, 18.3%), Pseudomonas aeruginosa (n = 302, 10.7%), and Aspergillus flavus (n = 236, 8.3%). Cornea transplantation was performed in 628 eyes to manage ongoing infection, but 289 grafts (46%) had failed by the end of the study. Moderate visual impairment (Snellen vision less than 20/60) was documented in 3478 eyes (53.6%). Conclusion: Demographic and risk factors for infection vary by country, but infections occur predominantly in male subjects and are frequently related to trauma. Overall, a similar percentage of bacterial and fungal infections were diagnosed in this study. Visual recovery after infectious keratitis is guarded, and corneal transplantation for active infection is associated with a high failure rate.
ISSN: 18791891
Appears in Collections:Scopus 2018

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