Corneal infection in Shandong peninsula of China: a 10-year retrospective study on 578 cases.

AIM To determine the epidemiological characteristics, clinical signs, laboratory findings, and outcomes in patients with corneal infection in Shandong peninsula of China. METHODS The medical records of 578 inpatients (578 eyes) with corneal infection were reviewed retrospectively for demographic characteristics, risk factors, seasonal variation, clinical signs, laboratory findings, and treatment strategy. Patient history, ocular examination findings using slit-lamp biomicroscopy, laboratory findings resulted from microbiological cultures, and treatment. RESULTS Fungal keratitis constituted 58.48% of cases of infectious keratitis among the inpatients, followed by herpes simplex keratitis (20.76%), bacterial keratitis (19.03%) and acanthamoeba keratitis (1.73%). The most common risk factor was corneal trauma (71.80%). The direct microscopic examination (338 cases) using potassium hydroxide (KOH) wet mounts was positive in 296 cases (87.57%). Among the 298 fungal culture-positive cases, Fusarium species were the most common isolates (70.47%). A total of 517 cases (89.45%) received surgical intervention, including 255 (44.12%) cases of penetrating keratoplasty, 74 (12.80%) cases of lamellar keratoplasty which has become increasingly popular, and 77 cases (13.32%) of evisceration or enucleation. CONCLUSION At present, infectious keratitis is a primary corneal disease causing blindness in China. With Fusarium species being the most commonly identified pathogens, fungal keratitis is the leading cause of severe infectious corneal ulcers in Shandong peninsula of China.

[1]  Stephanie Watson,et al.  Corneal blindness: a global problem , 2014, Clinical & experimental ophthalmology.

[2]  D. Glidden,et al.  Moxifloxacin susceptibility mediates the relationship between causative organism and clinical outcome in bacterial keratitis. , 2013, Investigative ophthalmology & visual science.

[3]  L. Hazlett,et al.  TREM-1 Amplifies Corneal Inflammation after Pseudomonas aeruginosa Infection by Modulating Toll-Like Receptor Signaling and Th1/Th2-Type Immune Responses , 2011, Infection and Immunity.

[4]  Emily W. Gower,et al.  Clinical and microbiological characteristics of fungal keratitis in the United States, 2001-2007: a multicenter study. , 2011, Ophthalmology.

[5]  Lixin Xie,et al.  Primary diseases of corneal perforation in Shandong Province, China: a 10-year retrospective study. , 2008, American journal of ophthalmology.

[6]  J. Scott,et al.  Therapeutic keratoplasty for advanced suppurative keratitis. , 2007, American journal of ophthalmology.

[7]  L. Hazlett,et al.  Spantide I decreases type I cytokines, enhances IL-10, and reduces corneal perforation in susceptible mice after Pseudomonas aeruginosa infection. , 2007, Investigative ophthalmology & visual science.

[8]  H. Taylor,et al.  Microbial Keratitis: Predisposing Factors and Morbidity , 2006 .

[9]  Xuguang Sun,et al.  Etiological analysis on ocular fungal infection in the period of 1989 - 2000. , 2004, Chinese medical journal.

[10]  Savitri Sharma,et al.  Evaluation of Corneal Scraping Smear Examination Methods in the Diagnosis of Bacterial and Fungal Keratitis: A Survey of Eight Years of Laboratory Experience , 2002, Cornea.