Epidemiology of corneal ulcers: a 6-year retrospective study in a general hospital
Session Details
Session Title: Presented Poster Session: Infection & Imaging
Venue: Poster Village: Pod 2
First Author: : M.Brízido PORTUGAL
Co Author(s): : B. Lopes P. Pereira I. Galvão A. Almeida
Abstract Details
Purpose:
Corneal ulcers are a significant cause of ocular morbidity. Most are infectious, with potential to permanently impair vision. Corneal scrapings are routinely performed in our hospital whenever the ulcer is larger than 2 mm, involves the central cornea or deep stroma, is unresponsive to initial treatment, or if history and clinical examination suggest unusual pathogens. The purpose of this study is to review the epidemiology of cultured corneal ulcers and risk factors associated with development of the ulcers, namely contact lenses wear.
Setting:
Data on corneal ulcer cases were reviewed by search of the ophthalmology and microbiology databases, allowing the creation of a cohort of patients who had undergone corneal scrapings for ulcers between 2013 and 2018. Clinical charts were then reviewed to identify associated risk factors.
Methods:
We conducted an uncontrolled, descriptive, retrospective study of 39 patients whose corneal ulcers were scraped and sent to laboratory investigation. All specimens were plated on culture media and cultured species were identified.
Results:
The average age of our patients was 60 years (18-90 years), with 1.6 male to female ratio (62% were males). Cultures yielded a positive result in 47% of the cases. Thirty one percent of patients were contact lenses wearers; the mean age of contact lens-related corneal ulcers (CLRU) was 47 years. Culture positive CLRU were predominantly gram-negatives (86%), with Pseudomonas aeruginosa and Serratia marcescens being the most common (each responsible for 29% of cases). The causative pathogen in non-CLRU was predominantly Staphylococcus aureus (45%), though Pseudomonas aeruginosa (18%), other gram-negatives (27%), gram-positives (9%) and Acanthamoeba (9%) were also seen.
Conclusions:
Most cases of culture positive corneal ulcers were in non-CLRU, which were frequently associated with Staphylococcus aureus. CLRU was associated with gram-negative species. These findings agree with the current trend on microbiological etiology of corneal ulcers in developed countries. Our yield of positive cultures was close to that reported in the literature (50-60%). Although empirical treatment alone might suffice, severe cases warrant a culture, as its results might dictate a modification of the treatment, with a resultant great impact on the outcome.
Financial Disclosure:
None