Diagnostic accuracy
What predicts bad outcomes in bacterial keratitis?
Open access · cc by · source: Europe PMC
In 283 UK eyes with suspected bacterial keratitis, almost all had a risk factor (OSD 47%, contact lenses 35%, immunosuppression 18%); age >50, infiltrate >3 mm, and poor presenting vision predicted worse vision and slow healing.
Study at a glance
- Design
- Cohort — Retrospective consecutive suspected bacterial keratitis presenting to Queen’s Medical Centre, Nottingham, 2015–2019 (Nottingham Infectious Keratitis Study).
- N
- N=283 · 283 patients / 283 eyes; mean age 54.4±21.0; 50.9% male; 45.2% culture-positive.
- Population
- Patients with suspected bacterial keratitis at a UK tertiary eye centre.
- Outcome
- Risk factors, culture results, hospitalisation/surgery, visual outcome (CDVA <0.6 logMAR), and delayed healing (>30 days).
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Key findings
128/283 (45.2%) culture-positive. Contact-lens cases linked to P. aeruginosa; non-CL cases to staphylococci (p=0.017). 57.2% hospitalized (mean 8.0 days); 16.3% needed surgery. Perforation 8.8%, NPL vision 3.9%, evisceration/enucleation 1.4%. Culture-positive eyes were older and more severe at presentation.
Methodology
Retrospective chart review of Queen’s Medical Centre BK suspects 2015–2019, comparing culture-positive vs negative presentations and modeling poor final CDVA (<0.6 logMAR) and delayed epithelial healing.
Limitations
Single-centre retrospective data cannot prove causality of risk factors or that earlier treatment would have changed every poor outcome; 55% culture-negative so organism effects are incomplete.
How this study connects
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