为了调查发病率,特点,危险因素,眼干燥综合征(SS)患者感染性角膜炎的治疗结果。
我们对2010年至2020年在首尔国立大学医院接受眼部SS随访的患者进行了回顾性分析,并确定了感染性角膜炎的病例。发病率,人口统计学和临床特征,危险因素,微生物概况,并对治疗结果进行了调查,其中一些与非SS组的感染性角膜炎病例进行了比较。
在929例眼部SS患者中,感染性角膜炎18眼(1.94%)。眼部SS组18例患者均为女性,非SS组100例感染性角膜炎患者中有48例(48%)为女性(p<0.01)。眼部SS组诊断感染性角膜炎的平均年龄为66.1岁,这与非SS组没有什么不同(57.2年,p=0.12)。分析了风险因素,治疗性接触镜的使用在眼部SS患者中更为频繁,与非SS患者相比(67%vs.11%,p<0.01)。眼部SS组的培养阳性率为50%。所有经培养证实的病例均为细菌感染,其中之一是细菌真菌混合感染。在平均29天的药物治疗后,所有眼睛的感染都消失了。除了另外需要玻璃体切除术的穿透性角膜移植术。分辨率提高15只眼(83%)。在平均55.7个月的随访中,三名患者(17%)复发了感染性角膜炎。
眼部SS患者感染性角膜炎的发生率为1.94%。大多数是细菌感染,并通过药物治疗解决。治疗和视觉结果是有利的,但复发发生率为17%。
To investigate the incidence, characteristics, risk factors, and treatment outcomes for infectious keratitis in patients with ocular Sjögren\'s syndrome (SS).
We performed a retrospective chart review of patients who had been followed up for ocular SS in Seoul National University Hospital from 2010 to 2020 and identified cases where infectious keratitis developed. The incidence, demographical and clinical characteristics, risk factors, microbiological profiles, and treatment outcome were investigated, some of which were compared with infectious keratitis cases in the non-SS group.
Out of 929 patients with ocular SS, infectious keratitis occurred in 18 eyes (1.94%). All 18 patients were female in the ocular SS group, while 48 out of 100 infectious keratitis patients (48%) were female in the non-SS group (p < 0.01). The mean age at diagnosis of infectious keratitis was 66.1 years in the ocular SS group, which was not different from the non-SS group (57.2 years, p = 0.12). Of risk factors analyzed, the use of therapeutic contact lens was more frequently used in the ocular SS patients, compared to the non-SS patients (67% vs. 11%, p < 0.01). Culture-positivity rate was 50% in the ocular SS group. All culture-proven cases were bacterial infection, one of which was bacterial-fungal coinfection. Infection resolved in all eyes after the mean 29 days of medical treatment, except one that additionally required penetrating keratoplasty with vitrectomy. The visual acuity improved in 15 eyes (83%) after resolution. Infectious keratitis recurred in three patients (17%) during the mean 55.7 months of follow-up.
The incidence of infectious keratitis was 1.94% in patients with ocular SS. Most were bacterial infections and resolved by medical treatment. Therapeutic and visual outcomes were favorable, but recurrence occurred in 17%.