Abstract：
OBJECTIVE: To study the risk factors, clinical features, and treatment outcomes of patients with culture-negative keratitis (CNK).
METHODS: A retrospective data review of 933 patients with CNK was performed from January 2018 to December 2020. The variables such as the history of injury, visual acuity, slit-lamp findings with measurements of size and depth of ulcer, microbiological evaluation, duct patency, blood glucose levels, and treatment were considered, and clinical outcome was analyzed.
RESULTS: Of the 933 patients with CNK, 763 (81.8%) were medically managed, with a mean treatment duration of 2.08 ± 1.7 weeks. Among them, 622 (66.7%) were both smear and culture-negative, and 311 (33.3%) showed only smear positivity. Smear-positive patients showed a positive correlation with the history of injury. A higher incidence of fungal growth on repeat culture was observed. Surgical interventions were done only in 18.2% of the patients; the rest were treated with topical medications alone.
CONCLUSIONS: High clinical suspicion, differentiation of causative organisms based on clinical findings, and initiating empirical therapy with broad-spectrum antibiotics and antifungals improve the ultimate prognosis in patients with CNK, even though a standard protocol for empirical medical treatment may differ among institutions and surgeons based on their clinical experience and geographical variations.
METHODS: A retrospective data review of 933 patients with CNK was performed from January 2018 to December 2020. The variables such as the history of injury, visual acuity, slit-lamp findings with measurements of size and depth of ulcer, microbiological evaluation, duct patency, blood glucose levels, and treatment were considered, and clinical outcome was analyzed.
RESULTS: Of the 933 patients with CNK, 763 (81.8%) were medically managed, with a mean treatment duration of 2.08 ± 1.7 weeks. Among them, 622 (66.7%) were both smear and culture-negative, and 311 (33.3%) showed only smear positivity. Smear-positive patients showed a positive correlation with the history of injury. A higher incidence of fungal growth on repeat culture was observed. Surgical interventions were done only in 18.2% of the patients; the rest were treated with topical medications alone.
CONCLUSIONS: High clinical suspicion, differentiation of causative organisms based on clinical findings, and initiating empirical therapy with broad-spectrum antibiotics and antifungals improve the ultimate prognosis in patients with CNK, even though a standard protocol for empirical medical treatment may differ among institutions and surgeons based on their clinical experience and geographical variations.
摘要：
目的：研究危险因素，临床特征,培养阴性角膜炎（CNK）患者的治疗结果。
方法：对2018年1月至2020年12月933例CNK患者进行回顾性资料回顾。诸如受伤史之类的变量，视敏度,通过测量溃疡的大小和深度来发现裂隙灯，微生物评价,管道通畅，血糖水平，并考虑了治疗，并对临床结局进行分析。
结果：在933名CNK患者中，763人（81.8%）接受医学管理，平均治疗时间为2.08±1.7周。其中,622（66.7％）均为涂片和培养阴性，311（33.3％）仅显示涂片阳性。涂片阳性患者与损伤史呈正相关。观察到重复培养时真菌生长的发生率较高。仅在18.2％的患者中进行了手术干预；其余的仅用局部药物治疗。
结论：临床高度怀疑，根据临床发现区分致病生物，开始使用广谱抗生素和抗真菌药物的经验性治疗可改善CNK患者的最终预后，即使经验性医学治疗的标准方案可能因机构和外科医生的临床经验和地理差异而有所不同。
方法：对2018年1月至2020年12月933例CNK患者进行回顾性资料回顾。诸如受伤史之类的变量，视敏度,通过测量溃疡的大小和深度来发现裂隙灯，微生物评价,管道通畅，血糖水平，并考虑了治疗，并对临床结局进行分析。
结果：在933名CNK患者中，763人（81.8%）接受医学管理，平均治疗时间为2.08±1.7周。其中,622（66.7％）均为涂片和培养阴性，311（33.3％）仅显示涂片阳性。涂片阳性患者与损伤史呈正相关。观察到重复培养时真菌生长的发生率较高。仅在18.2％的患者中进行了手术干预；其余的仅用局部药物治疗。
结论：临床高度怀疑，根据临床发现区分致病生物，开始使用广谱抗生素和抗真菌药物的经验性治疗可改善CNK患者的最终预后，即使经验性医学治疗的标准方案可能因机构和外科医生的临床经验和地理差异而有所不同。
