Comparison of Clinical Features and Treatment Outcomes of Ps
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A retrospective cohort study. 214 consecutive cases of Pseudomonas aeruginosa keratitis (PAK) were included between January 2006 and December 2019. Clinical features, microbiologic results, and treatment course were compared between contact lens wearers (CLW) and non-contact lens wearers (non-CLW) groups. Analyses of clinical features predicting poor final visual acuity (VA) were performed.

This study identified 214 infected eyes in 207 patients with PAK, including 163 eyes (76.2%) in CLW and 51 eyes (23.8%) in non-CLW. Average age was 39.2 years in CLW and 71.9 years in non-CLW (P < 0.0001). Average logMAR visual acuity (VA) at presentation was 1.39 in CLW and 2.17 in non-CLW (P < 0.0001); average final VA was 0.76 in CLW and 1.82 in non-CLW (P < 0.0001). Stromal necrosis required a procedural or surgical intervention in 13.5% of CLW and 49.0% of non-CLW (P < 0.0001). A machine learning-based analysis yielded a list of clinical features which most strongly predict a poor VA outcome (worse than 20/40), including worse initial VA, older age, larger size of infiltrate or epithelial defect at presentation, and greater maximal depth of stromal necrosis.

Non-CLW have significantly worse VA outcomes and required a higher rate of surgical intervention, compared with CLW. Our study elucidates risk factors for poor visual outcomes in non-CLW with PAK.

Read more : https://www.ajo.com/article/S0002-9394(21)00089-1/fulltext?rss=yes
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