Abstract：
OBJECTIVE: To describe the frequency, clinical presentation, and outcomes of neurotrophic keratopathy (NK).
METHODS: Retrospective cohort study of Kaiser Permanente Northern California patients diagnosed with NK using ICD-10 code H16.23X from October 1, 2016 through May 31, 2021 was conducted. The electronic medical record was used to obtain demographic information, systemic and ocular comorbidities, corrected distance visual acuity (CDVA), Mackie stage, laterality, etiology, complications, interventions, and medications. The data were analyzed using cross-tabulations.
RESULTS: 354 eyes in 322 patients presented with an initial or recurrent episode of NK. 9.9% had bilateral NK, 40% were 75 years and older, and 55% were women. Baseline vision was worse than 20/100 in 47.5%. Mackie staging was stage 1 in 37.3%, stage 2 in 32.5%, and stage 3 in 30.2%. Herpetic causes comprised 34.9%, followed by diabetes (12.4%), ocular surgery (10.4%), and central nervous system etiologies (9.0%). Topical antibiotics (74.5%), steroids (54.0%), autologous serum tears (46.0%), and oral antivirals (43.8%) were the most used treatments. There were 8 eyes with perforation, 4 endophthalmitis, and 3 evisceration/enucleations. An increased difference of approximately 0.1 logMAR in CDVA in the affected eye compared with the unaffected eye over one year was not statistically significant. Clinic utilization for stage 2 (average visits per month, 3.2) and stage 3 (5.0) NK gradually decreased over 6 months.
CONCLUSIONS: Summary of the current management, outcomes, and healthcare utilization of NK provides valuable benchmarks in assessing the disease burden in the community and for further development of novel therapies.
METHODS: Retrospective cohort study of Kaiser Permanente Northern California patients diagnosed with NK using ICD-10 code H16.23X from October 1, 2016 through May 31, 2021 was conducted. The electronic medical record was used to obtain demographic information, systemic and ocular comorbidities, corrected distance visual acuity (CDVA), Mackie stage, laterality, etiology, complications, interventions, and medications. The data were analyzed using cross-tabulations.
RESULTS: 354 eyes in 322 patients presented with an initial or recurrent episode of NK. 9.9% had bilateral NK, 40% were 75 years and older, and 55% were women. Baseline vision was worse than 20/100 in 47.5%. Mackie staging was stage 1 in 37.3%, stage 2 in 32.5%, and stage 3 in 30.2%. Herpetic causes comprised 34.9%, followed by diabetes (12.4%), ocular surgery (10.4%), and central nervous system etiologies (9.0%). Topical antibiotics (74.5%), steroids (54.0%), autologous serum tears (46.0%), and oral antivirals (43.8%) were the most used treatments. There were 8 eyes with perforation, 4 endophthalmitis, and 3 evisceration/enucleations. An increased difference of approximately 0.1 logMAR in CDVA in the affected eye compared with the unaffected eye over one year was not statistically significant. Clinic utilization for stage 2 (average visits per month, 3.2) and stage 3 (5.0) NK gradually decreased over 6 months.
CONCLUSIONS: Summary of the current management, outcomes, and healthcare utilization of NK provides valuable benchmarks in assessing the disease burden in the community and for further development of novel therapies.
摘要：
目的：为了描述频率，临床表现,和神经营养性角膜病变（NK）的结果。
方法：对2016年10月1日至2021年5月31日使用编码为H16.23X的KaiserPermanente北加州患者进行回顾性队列研究。电子病历被用来获取人口统计信息，全身和眼部合并症，矫正视力（CDVA），麦基舞台，偏侧性,病因学,并发症,干预措施，和药物。使用交叉表格分析数据。
结果：322例患者的354只眼表现为初次或反复发作的NK。9.9%有双侧NK，40%是75岁及以上,55%是女性。基线视力低于20/100的47.5%。Mackie分期是阶段1的37.3%，第二阶段32.5%，第三阶段为30.2%。疱疹病因占34.9%，其次是糖尿病(12.4%)，眼科手术（10.4%），中枢神经系统病因（9.0%）。外用抗生素（74.5%），类固醇（54.0%），自体血清泪液（46.0％），口服抗病毒药物（43.8％）是最常用的治疗方法。有8只眼睛穿孔，4眼内炎，和3次摘除内脏/摘除。与未受影响的眼睛相比，受影响的眼睛的CDVA中大约0.1logMAR的差异在一年内没有统计学意义。第二阶段的诊所利用率(每月平均就诊次数，3.2）和阶段3（5.0）NK在6个月内逐渐下降。
结论：当前管理摘要，结果，NK和医疗保健利用为评估社区疾病负担和进一步开发新疗法提供了有价值的基准。
方法：对2016年10月1日至2021年5月31日使用编码为H16.23X的KaiserPermanente北加州患者进行回顾性队列研究。电子病历被用来获取人口统计信息，全身和眼部合并症，矫正视力（CDVA），麦基舞台，偏侧性,病因学,并发症,干预措施，和药物。使用交叉表格分析数据。
结果：322例患者的354只眼表现为初次或反复发作的NK。9.9%有双侧NK，40%是75岁及以上,55%是女性。基线视力低于20/100的47.5%。Mackie分期是阶段1的37.3%，第二阶段32.5%，第三阶段为30.2%。疱疹病因占34.9%，其次是糖尿病(12.4%)，眼科手术（10.4%），中枢神经系统病因（9.0%）。外用抗生素（74.5%），类固醇（54.0%），自体血清泪液（46.0％），口服抗病毒药物（43.8％）是最常用的治疗方法。有8只眼睛穿孔，4眼内炎，和3次摘除内脏/摘除。与未受影响的眼睛相比，受影响的眼睛的CDVA中大约0.1logMAR的差异在一年内没有统计学意义。第二阶段的诊所利用率(每月平均就诊次数，3.2）和阶段3（5.0）NK在6个月内逐渐下降。
结论：当前管理摘要，结果，NK和医疗保健利用为评估社区疾病负担和进一步开发新疗法提供了有价值的基准。
