Incidence of ocular morbidity among multibacillary leprosy patients during a 2 year course of multidrug therapy.
OBJECTIVE
To evaluate the incidence of and risk factors for ocular complications in multibacillary (MB) leprosy patients during their 2 year, fixed duration, multidrug therapy (MDT).


METHODS
Periodic eye examinations were conducted prospectively on a cohort of 301 consecutive newly diagnosed MB patients every 6 months during their 2 year course of MDT. Incidence of ocular pathology was calculated as the number of events per person year of event free follow up of patients who did not have the specific finding at baseline.


RESULTS
292 (97%) patients had one or more follow up visits. The incidence of lagophthalmos was 1.2%/patient year (95% CI 0.5% to 2.8%); corneal opacity was 7.4%/patient year (95% CI 5.1% to 10.6%); uveal involvement was 5.1%/patient year (95% CI 3.3% to 7.8%), and cataract that reduced vision to 6/18 or less was seen in 4.3%/patient year (95% CI 2.7% to 6.9%) of patients. Overall, 23 individuals (5.8%/patient year, 95% CI 3.9 to 8.8) developed leprosy related potentially blinding pathology during the 2 years of MDT.


CONCLUSIONS
Approximately 20% of patients with MB leprosy can be expected to develop ocular complications of leprosy during a 2 year course of MDT, many (11%) of which are potentially vision threatening. Ophthalmological monitoring to detect and treat ocular complications at defined intervals during MDT is indicated.
Daniel
E
E
Schieffelin Leprosy Research and Training Centre, Vellore, India. edaniel4@jhmi.edu
Ffytche
T J
TJ
Sundar Rao
P S S
PS
Kempen
J H
JH
Diener-West
M
M
Courtright
P
P
D000328:Adult; D000367:Age Factors; D001431:Bacteriological Techniques; D004359:Drug Therapy, Combination; D005128:Eye Diseases / Q000175:diagnosis / Q000382:microbiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India; D007917:Leprostatic Agents / Q000627:therapeutic use*; D007918:Leprosy / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D013997:Time Factors
D007917:Leprostatic Agents