Incidence of ocular complications in patients with multibacillary leprosy after completion of a 2 year course of multidrug therapy.
OBJECTIVE
To evaluate the incidence of and risk factors for ocular complications in multibacillary (MB) leprosy patients following completion of 2 year, fixed duration, multidrug therapy (MDT).


METHODS
Biannual eye examinations were conducted prospectively on a cohort of MB patients who had completed MDT and followed up for 5 years. The 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 before completion of MDT.


RESULTS
278 patients had one or more follow up visits after completion of MDT. The incidence of lagophthalmos was 0.24%/patient year (95% CI 0.10% to 0.37%); corneal opacity, 5.35%/patient year (95% CI 4.27% to 6.70%); uveal involvement, 3.78%/patient year (95% CI 2.96% to 4.83%); and cataract that reduced vision to 6/18 or less, 2.4%/patient year (95% CI 1.77% to 3.26%). Overall, 5.65%/patient year (95% CI 4.51% to 7.09%) developed leprosy related ocular disease and 3.86%/patient year (95% CI 3.00% to 4.95%) developed leprosy related, potentially blinding ocular pathology during the period following MDT. Age and other disability also predicted incident eye disease.


CONCLUSIONS
Every year, approximately 5.6% of patients with MB who have completed MDT can be expected to develop new ocular complications of leprosy, which often (3.9%) are potentially vision threatening. Because many of these complications cannot be detected without slit lamp examination, periodic monitoring, particularly of older patients and those with other disability, is recommended, in order to detect and treat ocular complications satisfactorily.
Daniel
E
E
Schieffelin Leprosy Research and Training Centre, Vellore, Tamil Nadu, India. edaniel4@jhmi.edu
Ffytche
T J
TJ
Kempen
J H
JH
Rao
P S S Sundar
PS
Diener-West
M
M
Courtright
P
P
D000704:Analysis of Variance; D003318:Corneal Opacity / Q000382:microbiology; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007917:Leprostatic Agents / Q000627:therapeutic use*; D007918:Leprosy / Q000150:complications / Q000188:drug therapy*; D008297:Male; D012307:Risk Factors; D014603:Uveal Diseases / Q000382:microbiology; D014786:Vision Disorders / Q000382:microbiology
D007917:Leprostatic Agents