Microbial keratitis. A 4 year study of risk factors and traditional/complementary medicine in Oman

被引：11

作者：

Bialasiewicz A. ^{[1
,4
]}

Shenoy R. ^{[1
]}

Thakral A. ^{[1
]}

Al-Muniri A.A. ^{[2
]}

Shenoy U. ^{[3
]}

Al-Mughairi Z. ^{[3
]}

机构：

[1] Department of Ophthalmology, School of Ophthalmic Technicians, Sultan Qaboos University College of Medicine and Health Sciences, Al Khod/Muscat

[2] Department of Epidemiology and Medical Statistics, Sultan Qaboos University College of Medicine and Health Sciences

[3] Department of Microbiology, Sultan Qaboos University College of Medicine and Health Sciences

[4] Department of Ophthalmology, School of Ophthalmic Technicians, Sultan Qaboos University College of Medicine and Health Sciences

来源：

Der Ophthalmologe | 2006年 / 103卷 / 8期

关键词：

Alternative/complementary medicine; Contact lens; Keratitis; Trauma; Ushar;

D O I：

10.1007/s00347-006-1363-2

中图分类号：

学科分类号：

摘要：

Purpose. To determine the risk factors and the influence of complementary/alternative medicines (CAM) for infectious keratitis in a monsoon-free region of the Sultanate of Oman. Study design. Retrospective single center cohort study. Outcome measures. Demographic data, risk factors, and pathogens. Methods. Patients with purulent stromal keratitis admitted from 2001-2004 were evaluated for clinical and microbiological data, CAM use, duration of hospitalization, and outcome of treatment. Statistics. χ 2-test, Z-test. Results. A total of 320 patients (326 eyes) out of 7,524 admissions had severe infectious stromal keratitis requiring inpatient treatment. The average age was 35.1±2.5 years (range 1.5-63 years), the male:female ratio was 2:3 in the age group ≥13 years and 2:1 in the age group ≤12 years. Unsuccessful treatment by traditional healers prior to presentation was recorded for 203 patients (62.3%). Ocular risk factors included severe trachomatous dry eye conditions, meibomianitis and soft contact lens overwear. Systemic compromising risk factors were diabetes mellitus and medical immunosuppression. A total of 215 patient eyes (66%) had delayed or no healing (therapy drop-outs), and hospitalization (45 days) was significantly prolonged compared to the 111 antibiotic responders (26 days) (p<0.001). All eyes of patients with prior CAM had worse vision at admission and after therapy (p<0.001), and 97 eyes of patients with uncontrolled diabetes (p<0.001) and 68 eyes of patients with immunosuppression (p<0.001) had a poor visual outcome (vision <0.1). Thirteen eyes perforated. A negative microbiological result correlated with worse final vision (p<0.05). All 13 perforated eyes had received prior CAM (p<0.001). Conclusions. Trachoma, trauma and contact lens overwear are significant risk factors for infectious keratitis in Oman and correlate with specific age groups. Delay in treatment due to the first-line utilization of CAM showed a significant adverse impact on outcome. © Springer Medizin Verlag 2006.

引用

页码：682 / 687

页数：5

共 29 条

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