Improvement in corneal scarring following bacterial keratitis

McClintic, Scott M.; Srinivasan, Muthiah; Mascarenhas, Jeena; Greninger, Daniel A.; Acharya, Nisha R.; Lietman, Thomas M.; Keenan, Jeremy D.

doi:10.1038/eye.2012.270

Cited by 16 publications

(14 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Corneal scar removal is limited by the depth and regularity of the lesion. McClintic and colleagues have recently shown that scars from corneal ulcers continue to improve many months after initial infection. There have also been contemporary studies highlighting that optical coherence tomography‐guided transepithelial phototherapeutic keratectomy can result in excellent visual and anatomic outcomes in patients with anterior corneal scars .…”

Section: Discussionmentioning

confidence: 99%

Corneal epithelial debridement for diagnosis and therapy of ocular surface disease

McGrath

Lee

2015

Clinical and Experimental Optometry

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Corneal epithelial debridement for diagnosis and therapy of ocular surface disease

McGrath

Lee

2015

Clinical and Experimental Optometry

View full text Add to dashboard Cite

show abstract

“…On the other hand, ulcers in general may take more than 3 months to reach their visual potential. 17 SCUT was designed with a 12-month follow-up visit to examine such longer term effects. Here, we present the 12-month clinical outcomes of this trial.…”

Section: Introductionmentioning

confidence: 99%

The Steroids for Corneal Ulcers Trial (SCUT): Secondary 12-Month Clinical Outcomes of a Randomized Controlled Trial

Srinivasan

Mascarenhas

Rajaraman

et al. 2014

American Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose To determine whether topical corticosteroids as adjunctive therapy for bacterial keratitis improves long-term clinical outcomes. Design Randomized placebo-controlled double-masked clinical trial. Methods This multicenter trial compared 1.0% prednisolone sodium phosphate to placebo in the treatment of bacterial keratitis among 500 patients with culture-positive ulcers receiving 48 hours of moxifloxacin before randomization. The primary endpoint was 3 months from enrollment, and 399 patients were evaluated at 12 months. The outcomes examined were best spectacle-corrected visual acuity (BSCVA) and scar size at 12 months. Based on previous results, regression models with adjustments for baseline status and/or causative organism were used for analysis. Results No significant differences in clinical outcomes by treatment group were seen with the pre-specified regression models (BSCVA: −0.04 logMAR, 95%CI, −0.12 to 0.05, P=0.39; scar size: 0.03mm, 95% CI, −0.12 to 0.18, P=0.69). A regression model including a Nocardia-treatment arm interaction found corticosteroid use associated with a mean one-line improvement in BSCVA at 12 months among patients with non-Nocardia ulcers (−0.10 logMAR, 95%CI, −0.19 to −0.02, P=0.02). No significant difference was observed in 12-month BSCVA for Nocardia ulcers (0.18 logMAR, 95% CI, −0.04 to 0.41, P=0.16). Corticosteroids were associated with larger mean scar size at 12 months among Nocardia ulcers (0.47mm, 95% CI, 0.06 to 0.88, P=0.02) and no significant difference was identified by treatment for scar size for non-Nocardia ulcers (−0.06mm, 95%CI, −0.21 to 0.10, P=0.46). Conclusions Adjunctive topical corticosteroid therapy may be associated with improved long-term clinical outcomes in bacterial corneal ulcers not caused by Nocardia species.

show abstract

“…Many investigations evaluating strategies to decrease corneal scar formation after treatment of infectious keratitis are currently in progress; SCUT is representative of these efforts. 4 – 7 , 24 , 25 According to recent reports, the primary outcome of this trial revealed no benefit of adjunctive corticosteroids at 3 months after enrollment. Despite a possible delay in epithelial healing, no harm was observed with the use of corticosteroids.…”

Section: Discussionmentioning

confidence: 81%

“… 4 – 6 In SCUT, corneal scarring resulting from bacterial keratitis was noted to improve over time with corticosteroid treatment; the density of the scar-related opacity improved, leading to a concurrent improvement in vision. 7 However, corticosteroids may also significantly slow the process of corneal wound healing, prolong infection, and predispose to stromal thinning and perforation. 6 – 8 Therefore, treatments to reduce corneal scar formation without adverse effects, such as delayed re-epithelialization or perforation, are sought.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Systemic Vitamin C Supplementation in Reducing Corneal Opacity Resulting from Infectious Keratitis

et al. 2014

View full text Add to dashboard Cite

The objective of this study was to determine the effect of vitamin C supplementation on reducing the size of corneal opacity resulting from infectious keratitis.The study included 82 patients (82 affected eyes), admitted for infectious keratitis from January 2009 to August 2013, who were followed for more than 3 months. Patients were divided into control, oral vitamin C (3 g/d), and intravenous vitamin C (20 g/d) groups during hospitalization. Corneal opacity sizes were measured using anterior segment photographs and Image J program (version 1.27; National Institutes of Health, Jinju, South Korea) at admission, discharge, and final follow-up. The corneal opacity size used for analysis was the measured opacity size divided by the size of the whole cornea.The corneal opacity size decreased by 0.03 ± 0.10 in the oral vitamin C group, 0.07 ± 0.22 in the intravenous vitamin C group, and 0.02 ± 0.15 in the control group. Intravenous vitamin C reduced the corneal opacity size more than oral vitamin C (P = 0.043). Intravenous vitamin C produced greater reduction in corneal opacity size in younger patients (P = 0.015) and those with a hypopyon (P = 0.036).Systemic vitamin C supplementation reduced the size of corneal opacity resulting from infectious keratitis. Intravenous vitamin C was more beneficial than oral supplementation, especially in younger patients and those with hypopyon.

show abstract

Improvement in corneal scarring following bacterial keratitis

Cited by 16 publications

References 4 publications

Corneal epithelial debridement for diagnosis and therapy of ocular surface disease

Corneal epithelial debridement for diagnosis and therapy of ocular surface disease

The Steroids for Corneal Ulcers Trial (SCUT): Secondary 12-Month Clinical Outcomes of a Randomized Controlled Trial

Efficacy of Systemic Vitamin C Supplementation in Reducing Corneal Opacity Resulting from Infectious Keratitis

Contact Info

Product

Resources

About