title: Elevated intraocular pressure is a common complication during active microbial keratitis.
abstract: OBJECTIVE
  To determine the incidence, risk factor, and outcomes of elevated intraocular pressure (IOP) during active microbial keratitis.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  One hundred eighty-four patients with culture-proven microbial keratitis examined from January 2003 through December 2007 were included. High IOP was defined as IOP of 22 mm Hg or higher measured during the episode of active keratitis. The control group consisted of eyes with microbial keratitis whose IOP remained less than 22 mm Hg. Twelve factors were evaluated by univariate and multivariate analyses to determine whether any were associated with increased IOP. The incidence, risk factors, microbial profile, the necessity of therapeutic surgery, time to resolution, and final visual acuity were compared between the high IOP group and the control group.
  
  
  RESULTS
  High IOP (mean, 29.1 mm Hg; range, 22 to 51 mm Hg) occurred in 52 (28%) of 184 patients with active corneal infection. Prior ocular surgery, diabetes mellitus, and ulcer size of 4.0 mm or larger were associated with IOP elevation (P ≤ .013). Surgical interventions were necessary in 19 (39%) of 49 patients in the high IOP group and in 14 (11%) of 129 patients in the control group (P < .0001). Time to ulcer resolution was longer in the high IOP group (mean, 50.1 ± 53.2 days) than in the control (mean, 31.6 ± 42.0 days; P = .005). Final visual acuity of 20/40 or better was achieved by more patients in the control group (47%) than in the high IOP group (20%; P < .001).
  
  
  CONCLUSIONS
  Elevated IOP was detected in a significant proportion of patients with active microbial keratitis and was associated with poorer outcomes. Routine IOP check should be performed to avoid possible optic nerve damage.
authors.affiliation: Jules Stein Eye Institute, University of California, Los Angeles, 90095, USA.
authors.forename: Siamak
authors.initials: S
authors.lastname: Zarei-Ghanavati
authors.forename: Elmira
authors.initials: E
authors.lastname: Baghdasaryan
authors.forename: Arturo
authors.initials: A
authors.lastname: Ramirez-Miranda
authors.forename: Myhanh
authors.initials: M
authors.lastname: Nguyen
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.forename: Grace J
authors.initials: GJ
authors.lastname: Lee
authors.forename: Sophie X
authors.initials: SX
authors.lastname: Deng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D003320:Corneal Ulcer / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000382:microbiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014065:Tonometry, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult