Three Decades of Contact Lens-associated Microbial Keratitis in a Referral Hospital in São Paulo, Brazil

Agi, Jorge; Rocchetti, Talita Trevizani; Yu, Maria Cecília Zorat; Farah, Michelle Lima; Ramos, Fábio; Freitas, Denise de; Höfling-Lima, Ana Luísa

doi:10.5935/0004-2749.20210079

Cited by 8 publications

(6 citation statements)

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“…Contact lens use remains the most common risk factor for microbial keratitis, especially in young adults [6–9]. Infection risk is lowest with daily disposable and highest in extended wear, with overnight use of each significantly increasing the probability of infection [1 ▪ ,10].…”

Section: Epidemiologymentioning

confidence: 99%

“…Although Staphylococcus and Streptococcus species are common causes of all microbial keratitis, Pseudomonas aeruginosa has the strongest correlation with contact lens use [6][7][8][9]18]. Fungal and Acanthamoeba keratitis comprise a smaller, but significant proportion of CLMK [9,18,19]. In particular, the rise of Fusarium among fungal keratitis has been strongly correlated with contact lens use [19][20][21].…”

Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

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Therapy for contact lens-related ulcers

Jeang

Tuli

2022

Current Opinion in Ophthalmology

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Purpose of reviewThe current review covers the current literature and practice patterns of antimicrobial therapy for contact lens-related microbial keratitis (CLMK). Although the majority of corneal ulcers are bacterial, fungus and acanthamoeba are substantial contributors in CLMK and are harder to treat due to the lack of commercially available topical medications and low efficacy of available topical therapy.Recent findingsTopical antimicrobials remain the mainstay of therapy for corneal ulcers. Fluoroquinolones may be used as monotherapy for small, peripheral bacterial ulcers. Antibiotic resistance is a persistent problem. Fungal ulcers are less responsive to topical medications and adjunct oral or intrastromal antifungal medications may be helpful. Acanthamoeba keratitis continues to remain a therapeutic challenge but newer antifungal and antiparasitic agents may be helpful adjuncts. Other novel and innovative therapies are being studied currently and show promise.SummaryContact lens-associated microbial keratitis is a significant health issue that can cause vision loss. Treatment remains a challenge but many promising diagnostics and procedures are in the pipeline and offer hope.

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Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

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Therapy for contact lens-related ulcers

Jeang

Tuli

2022

Current Opinion in Ophthalmology

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“…при кератитах, развившихся на фоне ношения контактных линз [3,4]. Факторы риска развития микробного кератита, связанного с КЛ, включают: молодой возраст, мужской пол, сон в контактных линзах, превышение допустимой продолжительности использования, нарушение правил хранения и обработки КЛ и контейнеров для их хранения [5,6].…”

Section: Introductionunclassified

Acute Purulent Keratitis of Mixed Etiology Developed during Contact Lens Wearing. Clinical Case

et al. 2023

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The article presents a description of a clinical case of advanced purulent keratitis of mixed etiology (Pseudomonas aeruginosa + acanthamoeba), developed as a result of a mode violation of soft contact lens wearing. Confocal microscopy of the cornea revealed multiple rounded hyperreflective formations (acanthamoeba cysts). Complex anti-infective conservative therapy in combination with modified crosslinking stops rapidly progressing purulent keratitis and increases visual acuity from 0.01 to 0.9.

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“…6,12,13 이는 타 연구들에서도 비슷하였는데, 콘택트 렌즈 감염각막염의 배양 양성률은 국내의 Tchah et al 12 (54.0%), 터키의 Karaca et al 5 (64.5%), 브라질의 Agi et al 13 (52.9%) 등의 보고에서처럼 비교적 높은 경향을 보이고 있 30 임상적 으로 감염각막염으로 여겨지는 경우에는 배양검사를 통해 미생물을 확인하는 노력이 중요하다. 한편 그럼에도 불구…”

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Comparative Analysis of Contact Lens-related Bacterial Keratitis According to Culture Positivity: A 25-year Retrospective Study

Son,

Moon,

Cho

et al. 2023

J Korean Ophthalmol Soc

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Purpose: This study investigated the microbiological profile and clinical characteristics of culture positive (CP) contact lens-related bacterial keratitis (CLBK) and compared them to culture negative (CN) cases.Methods: We retrospectively analyzed 142 CLBK patients hospitalized between January 1998 and December 2022. The CP and CN groups consisted of 79 eyes (100 isolates) and 63 eyes, respectively. We investigated the microbiological profile in the CP group and compared the epidemiology, predisposing factors, clinical characteristics, and treatment outcomes between the CP and CN groups. Poor treatment outcomes were defined as a final best-corrected visual acuity (BCVA) ≤ 0.5, worsened BCVA after treatment, or the need for surgical intervention. We evaluated the risk factors for poor treatment outcomes in the entire cohort through two-proportional Z-test analysis.Results: In CP group, gram-negative bacteria accounted for 85%, and common isolates were Pseudomonas (27%) and Serratia (26%) species. There were significant differences in mean age (27.0 years vs. 33.8 years, p = 0.009) and a history of therapeutic bandage contact lens wear (13.9% vs. 28.6%, p = 0.031) between the CP and CN groups. However, there were no significant differences in symptom duration, prior use of topical antibiotics, sleeping with wearing CL, epithelial defect size, hypopyon, and poor treatment outcomes. Significant risk factors for poor treatment outcomes in the entire group included deep infiltration (Z = 2.88), epithelial healing time ≥ 7 days (Z = 2.30), initial BCVA < 0.1 (Z = 2.20), over date use of contact lens (Z = 2.10), and epithelial defect size ≥ 5 mm2 (Z = 2.05).Conclusions: There were no significant differences in clinical characteristics and treatment outcomes between the CP and CN groups. Poor initial clinical findings and over date use of contact lens were associated with poor treatment outcomes in both groups.

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Three Decades of Contact Lens-associated Microbial Keratitis in a Referral Hospital in São Paulo, Brazil

Cited by 8 publications

References 0 publications

Therapy for contact lens-related ulcers

Therapy for contact lens-related ulcers

Acute Purulent Keratitis of Mixed Etiology Developed during Contact Lens Wearing. Clinical Case

Comparative Analysis of Contact Lens-related Bacterial Keratitis According to Culture Positivity: A 25-year Retrospective Study

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