Demographic Characteristics, Clinical Presentations, and Risk Factors Impacting Visual Outcomes in Peripheral Ulcerative Keratitis.

IF 1.9 3区医学 Q2 OPHTHALMOLOGY Cornea Pub Date : 2024-12-01 Epub Date: 2024-03-14 DOI:10.1097/ICO.0000000000003541

Rohan Bir Singh, Sarah Atta, Divya Srikumaran, Vishal Jhanji

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Abstract

Purpose: To assess the demographic characteristics, ophthalmic and systemic presentations, and risk factors impacting the outcomes in patients diagnosed with peripheral ulcerative keratitis (PUK).

Methods: This retrospective study includes patients diagnosed with PUK at a tertiary care center over 13 years. A descriptive analysis of the demographics, clinical history, and presentation was performed. A reverse risk analysis was performed to assess the PUK resolution in patients with underlying autoimmune and non-autoimmune etiologies. Finally, we evaluated the correlation between treatment duration and final best corrected visual acuity (BCVA) and continuous and categorical variables.

Results: A total of 58 eyes of 51 patients with a mean age of 59.67 ± 13.41 years diagnosed with PUK were included in the study; 58.82% were female. The resolution duration was significantly shorter in patients with autoimmune etiologies (vs. non-autoimmune etiologies, P = 0.028) and female patients (vs. male patients, P = 0.008). The BCVA worsened in patients with non-autoimmune etiologies after treatment ( P = 0.17). Despite worse BCVA at presentation in patients with underlying autoimmune etiologies, significantly better final vision outcomes were observed ( P = 0.04). Linear regression analysis showed that longer treatment duration ( P = 0.001; R 2 = 0.1704) and worse vision ( P = 0.002; R 2 = 0.1502) at presentation were the primary risk factors of poor vision outcomes. Similarly, the treatment duration was significantly longer in male compared with female patients ( P < 0.001; R 2 = 0.2027).

Conclusions: The clinical outcomes in PUK with underlying autoimmune disorders were observed to be better than non-autoimmune etiologies, which may be attributed to the early detection of the PUK-related changes and aggressive medical management. A delayed diagnosis of PUK leads to poor vision outcomes.

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外周溃疡性角膜炎患者的人口统计学特征、临床表现以及影响视觉效果的风险因素。

目的：评估被诊断为周围性溃疡性角膜炎（PUK）患者的人口统计学特征、眼部和全身表现以及影响预后的风险因素：这项回顾性研究包括 13 年来在一家三级医疗中心确诊的 PUK 患者。对人口统计学、临床病史和表现进行了描述性分析。我们还进行了反向风险分析，以评估潜在自身免疫和非自身免疫病因患者的 PUK 缓解情况。最后，我们评估了治疗时间与最终最佳矫正视力（BCVA）之间的相关性以及连续变量和分类变量：本研究共纳入了 51 名 PUK 患者的 58 只眼睛，患者平均年龄为（59.67 ± 13.41）岁，其中 58.82% 为女性。自身免疫性病因患者（与非自身免疫性病因患者相比，P = 0.028）和女性患者（与男性患者相比，P = 0.008）的缓解持续时间明显较短。治疗后，非自身免疫性病因患者的 BCVA 有所恶化（P = 0.17）。尽管有潜在自身免疫病因的患者发病时 BCVA 较差，但最终视力结果却明显更好（P = 0.04）。线性回归分析显示，治疗时间较长（P = 0.001；R2 = 0.1704）和发病时视力较差（P = 0.002；R2 = 0.1502）是视力不良的主要风险因素。同样，男性患者的治疗时间明显长于女性患者（P < 0.001; R2 = 0.2027）：结论：与非自身免疫性病因相比，伴有潜在自身免疫性疾病的 PUK 的临床疗效更好，这可能归功于早期发现 PUK 相关病变和积极的医疗管理。PUK 诊断延迟会导致视力低下。

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来源期刊

Cornea 医学-眼科学

CiteScore

5.20

自引率

10.70%

发文量

354

审稿时长

3-6 weeks

期刊介绍： For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.