Outcomes of Pythium keratitis: a meta-analysis of individual patient data.

IF 0.9 Q4 OPHTHALMOLOGY Current Ophthalmology Reports Pub Date : 2022-12-01 Epub Date: 2022-11-10 DOI:10.1007/s40135-022-00302-7

Binh Cao, Vishnu Teja Gonugunta, Naveen Radhakrishnan, Prajna Lalitha, Bharat Gurnani, Kirandeep Kaur, Geetha Iyer, Shweta Agarwal, Bhaskar Srinivasan, Jeremy D Keenan, N Venkatesh Prajna

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引用次数: 1

Abstract

Background: Pythium keratitis is a difficult-to-treat corneal infection.

Methods: A meta-analysis of individual patient data from observational studies of Pythium keratitis was performed. The outcomes of interest were therapeutic penetrating keratoplasty (TPK) and globe removal (evisceration, enucleation, or exenteration); the main exposures were linezolid and azithromycin use.

Findings: Of 46 eligible articles, individual patient data were available for 306 eyes (34 studies). Pythium keratitis was associated with high rates of TPK (80%, 95%CI 70-87%) and globe removal (25%, 95%CI 13-43). In multivariable models adjusting for age and country, fewer TPKs were performed in patients treated with azithromycin (RR=0.80, 95%CI 0.67-0.96; P=0.04) and linezolid (RR=0.82, 95%CI 0.67-0.99; P=0.02).

Conclusions: Studies of Pythium keratitis reported high rates of TPK and globe removal. Use of azithromycin and linezolid was associated with a lower rate of TPK. While promising, these results should be interpreted with caution given the biases inherent to observational studies.

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角膜炎的预后:个体患者数据的荟萃分析。

背景:角膜炎是一种难治性角膜感染。方法:对来自角膜炎观察性研究的个体患者数据进行荟萃分析。关注的结果是治疗性穿透性角膜移植术(TPK)和眼球摘除(剜出、去核或剜出);主要暴露是利奈唑胺和阿奇霉素的使用。结果:在46篇符合条件的文章中，可获得306只眼睛(34项研究)的个体患者数据。角膜炎与高TPK率(80%，95%CI 70-87%)和球清除率(25%，95%CI 13-43)相关。在调整年龄和国家的多变量模型中，接受阿奇霉素治疗的患者较少进行TPKs (RR=0.80, 95%CI 0.67-0.96;P=0.04)和利奈唑胺(RR=0.82, 95%CI 0.67-0.99;P = 0.02)。结论:对角膜炎的研究报告了较高的TPK和球体去除率。使用阿奇霉素和利奈唑胺与较低的TPK率相关。虽然有希望，但考虑到观察性研究固有的偏差，这些结果应该谨慎解释。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Ophthalmology Reports Medicine-Ophthalmology

CiteScore

2.00

自引率

0.00%

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期刊介绍： This journal aims to offer expert review articles on the most significant recent developments in the field of ophthalmology. By providing clear, insightful, balanced contributions, the journal intends to serve those who diagnose, treat, manage, and prevent ocular conditions and diseases. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An Editorial Board of more than 20 internationally diverse members reviews the annual table of contents, ensures that topics include emerging research, and suggests topics of special importance to their country/region. Topics covered may include age-related macular degeneration; diabetic retinopathy; dry eye syndrome; glaucoma; pediatric ophthalmology; ocular infections; refractive surgery; and stem cell therapy.