Bacterial Keratitis in Type 1 Diabetic Patients: Course and Consequences

O. Zavoloka, P. Bezditko
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Abstract

The purpose was to define the peculiarities of the course and consequences of bacterial keratitis in patients with type 1 diabetes mellitus (DM1) depending on the stage of its severity. Methods. 34 DM1 patients (34 eyes) with bacterial keratitis whose initial bacteriological examination revealed pathogen sensitivity to the antibiotic ofloxacin participated in this study. All patients were treated topically with ofloxacin, antiseptics, repairing agents, antioxidants, mydriatics, artificial tears and systemically with anti-inflammatory agents. Patients were divided into two groups according to the severity of bacterial keratitis at the first visit. Research methods were as follows: visual acuity, tonometry, slit-lamp biomicroscopy of anterior and posterior eye segments, fluorescein dye test, non-contact corneal esthesiometry, anterior eye OCT and bacteriological studies. Results. Compared to the stage I, DM1 patients with stage II severity bacterial keratitis showed higher degree of pericorneal injection, larger and deeper corneal ulcer defect, deeper corneal infiltration and edema, higher mean corneal sensitivity threshold at all time point of the study, p<0.05. DM1 patients with stage II severity bacterial keratitis were more prone for longer duration of the disease and worse consequences. Therefore, on day 24 in 33.3% diabetic patients with stage II severity bacterial keratitis corneal ulcer was not found to be healed. Conclusions. Course and consequences of bacterial keratitis in type 1 diabetes mellitus patients depend on the stage of severity of bacterial keratitis.
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细菌性角膜炎在1型糖尿病患者:过程和后果
目的是确定1型糖尿病(DM1)患者细菌性角膜炎病程和后果的特点,这取决于其严重程度的分期。方法:对细菌性角膜炎DM1患者34例(34眼)进行初步细菌学检查,发现病原菌对氧氟沙星敏感。所有患者均局部应用氧氟沙星、防腐剂、修复剂、抗氧化剂、水杨剂、人工泪液,全身应用抗炎药。根据首次就诊时细菌性角膜炎的严重程度将患者分为两组。研究方法:视敏度、眼压测定、眼前、眼后段裂隙灯生物显微镜、荧光素染色试验、非接触角膜感觉测定、眼前OCT及细菌学研究。结果。DM1合并II期严重细菌性角膜炎患者与I期患者相比,在各时间点角膜周注射程度更高,角膜溃疡缺损更大更深,角膜浸润和水肿更深,平均角膜敏感阈值更高,p<0.05。伴有II期严重细菌性角膜炎的DM1患者更容易出现病程更长的疾病和更严重的后果。因此,33.3%的糖尿病II期严重细菌性角膜炎患者在第24天发现角膜溃疡未愈合。结论。1型糖尿病患者细菌性角膜炎的病程和后果取决于细菌性角膜炎严重程度的分期。
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