Infectious Keratitis in Patients with Ocular Sjögren’s Syndrome
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Purpose: To investigate the incidence, characteristics, risk factors, and treatment outcomes for infectious keratitis in patientswith ocular Sjögren’s syndrome (SS). Methods: We performed a retrospective chart review of patients who had been followed up for ocular SS in Seoul NationalUniversity Hospital from 2010 to 2020 and identified cases where infectious keratitis developed. The incidence, demographicaland clinical characteristics, risk factors, microbiological profiles, and treatment outcome were investigated, some of whichwere compared with infectious keratitis cases in the non-SS group. Results: Out of 929 patients with ocular SS, infectious keratitis occurred in 18 eyes (1.94%). All 18 patients were female in theocular SS group, while 48 out of 100 infectious keratitis patients (48%) were female in the non-SS group (p < 0.01). The meanage 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 SSpatients, compared to the non-SS patients (67% vs. 11%, p < 0.01). Culture-positivity rate was 50% in the ocular SS group. Allculture-proven cases were bacterial infection, one of which was bacterial-fungal coinfection. Infection resolved in all eyesafter 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 themean 55.7 months of follow-up. Conclusions: The incidence of infectious keratitis was 1.94% in patients with ocular SS. Most were bacterial infections andresolved by medical treatment. Therapeutic and visual outcomes were favorable, but recurrence occurred in 17%.
Abstract
Purpose: To investigate the incidence, characteristics, risk factors, and treatment outcomes for infectious keratitis in patientswith ocular Sjögren’s syndrome (SS). Methods: We performed a retrospective chart review of patients who had been followed up for ocular SS in Seoul NationalUniversity Hospital from 2010 to 2020 and identified cases where infectious keratitis developed. The incidence, demographicaland clinical characteristics, risk factors, microbiological profiles, and treatment outcome were investigated, some of whichwere compared with infectious keratitis cases in the non-SS group. Results: Out of 929 patients with ocular SS, infectious keratitis occurred in 18 eyes (1.94%). All 18 patients were female in theocular SS group, while 48 out of 100 infectious keratitis patients (48%) were female in the non-SS group (p < 0.01). The meanage 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 SSpatients, compared to the non-SS patients (67% vs. 11%, p < 0.01). Culture-positivity rate was 50% in the ocular SS group. Allculture-proven cases were bacterial infection, one of which was bacterial-fungal coinfection. Infection resolved in all eyesafter 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 themean 55.7 months of follow-up. Conclusions: The incidence of infectious keratitis was 1.94% in patients with ocular SS. Most were bacterial infections andresolved by medical treatment. Therapeutic and visual outcomes were favorable, but recurrence occurred in 17%.
참고문헌 (19)
- Negrini S, "Sjogren’s syndrome : a systemic autoimmune disease", Clin Exp Med, 22, pp.9~25 (2022)
- Kim HJ, "Incidence, mortality, and causes of death in physician-diagnosed primary Sjogren’s syndrome in Korea: a nationwide, population-based study", Semin Arthritis Rheum, 47, pp.222~227 (2017)
- Goules AV, "Classification criteria of Sjogren’s syndrome", J Autoimmun, 48-49, pp.42~45 (2014)
- Pasoto SG, "Sjogren’s syndrome and systemic lupus erythematosus : links and risks", Open Access Rheumatol, 11, pp.33~45 (2019)
- Akpek EK, "Sjogren’s syndrome : more than just dry eye", Cornea, 38, pp.658~661 (2019)
- Rosenbaum JT, "Chronic anterior and posterior uveitis and primary Sjogren’s syndrome", Am J Ophthalmol, 104, pp.346~352 (1987)
- Bamrolia NR, "Unusual presentation of a case of Sjogren’s syndrome with neurological and ocular manifestation", Cont Lens Anterior Eye, 35, pp.85~88 (2012)
- Akpek EK, "Ocular and systemic morbidity in a longitudinal cohort of Sjögren’s syndrome", Ophthalmology, 122, pp.56~61 (2015)
- Pascolini D, "Global estimates of visual impairment : 2010", Br J Ophthalmol, 96, pp.614~618 (2012)
- Ting DS, "Infectious keratitis:an update on epidemiology, causative microorganisms, risk factors, and antimicrobial resistance", Eye (Lond), 35, pp.1084~1101 (2021)
- Koh YY, "Epidemiology and the estimated burden of microbial keratitis on the health care system in Taiwan : a 14-year population-based study", Am J Ophthalmol, 220, pp.152~159 (2020)
- Erie JC, "Incidence of ulcerative keratitis in a defined population from 1950through 1988", Arch Ophthalmol, 111, pp.1665~1671 (1993)
- Jeng BH, "Epidemiology of ulcerative keratitis in Northern California", Arch Ophthalmol, 128, pp.1022~1028 (2010)
- Brandt JE, "Sex differences in Sjogren’s syndrome : a comprehensive review of immune mechanisms", Biol Sex Differ, 6, pp.19~ (2015)
- Mun Y, "Ten-year analysis of microbiological profile and antibiotic sensitivity for bacterial keratitis in Korea", PLoS One, 14, pp.e0213103~ (2019)
- Shalchi Z, "Antibiotic resistance in microbial keratitis : ten-year experience of corneal scrapes in the United Kingdom", Ophthalmology, 118, pp.2161~2165 (2011)
- Peng MY, "Bacterial keratitis : isolated organisms and antibiotic resistance patterns in San Francisco", Cornea, 37, pp.84~87 (2018)
- Jin H, "Evolving risk factors and antibiotic sensitivity patterns for microbial keratitis at a large county hospital", Br J Ophthalmol, 101, pp.1483~1487 (2017)
- Termote K, "Epidemiology of bacterial corneal ulcers at tertiary centres in Vancouver, B.C", Can J Ophthalmol, 53, pp.330~336 (2018)