title: Predictors of outcome in fungal keratitis.
abstract: OBJECTIVE
  To analyse predictors of clinical outcome in fungal keratitis.
  
  
  METHODS
  Data was collected during a prospective, randomized, controlled, double-masked clinical trial of treatment for fungal keratitis. Clinical features at presentation and demographics were collected at the enrollment visit for all patients. Pre-specified clinical outcomes included 3-month visual acuity and infiltrate/scar size, time to re-epithelialization, and corneal perforation. A separate multivariable model with each outcome as the dependent variable included all predictor variables.
  
  
  RESULTS
  Predictors for worse 3-month visual acuity include older age (P=0.024), worse presentation visual acuity (P<0.001), larger infiltrate size at presentation (P<0.001), and pigmented ulcer (P=0.030). Larger infiltrate size at presentation was a significant predictor of worse 3-month infiltrate/scar size (P<0.001). Larger epithelial defect size was a significant predictor of perforation (P=0.0013). Predictors of longer time to re-epithelialization include infiltrate size at presentation (P<0.001) and older age (P=0.025).
  
  
  CONCLUSIONS
  Ulcer severity at presentation is highly predictive of worse outcomes. Presentation of clinical characteristics such as baseline acuity and infiltrate scar can provide important information to clinicians about prognosis, and may help guide management and treatment decisions. Prevention of corneal ulcer remains important, as it is difficult to change the course of the ulcer once it has begun.
authors: Aravind Eye Care System, Madurai, India.
authors: N Venkatesh
authors: NV
authors: Prajna
authors: T
authors: T
authors: Krishnan
authors: J
authors: J
authors: Mascarenhas
authors: M
authors: M
authors: Srinivasan
authors: C E
authors: CE
authors: Oldenburg
authors: C M
authors: CM
authors: Toutain-Kidd
authors: A
authors: A
authors: Sy
authors: S D
authors: SD
authors: McLeod
authors: M E
authors: ME
authors: Zegans
authors: N R
authors: NR
authors: Acharya
authors: T M
authors: TM
authors: Lietman
authors: T C
authors: TC
authors: Porco
mesh_terms: D000287:Administration, Topical; D000935:Antifungal Agents / Q000627:therapeutic use; D057112:Corneal Perforation / Q000175:diagnosis; D003320:Corneal Ulcer / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D003646:Debridement; D004311:Double-Blind Method; D015821:Eye Infections, Fungal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D010866:Natamycin / Q000627:therapeutic use; D009883:Ophthalmic Solutions; D010043:Outcome and Process Assessment, Health Care; D011379:Prognosis; D011446:Prospective Studies; D011743:Pyrimidines / Q000627:therapeutic use; D062326:Re-Epithelialization; D012307:Risk Factors; D013997:Time Factors; D014230:Triazoles / Q000627:therapeutic use; D014792:Visual Acuity / Q000502:physiology; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D009883:Ophthalmic Solutions; D011743:Pyrimidines; D014230:Triazoles; D010866:Natamycin; D065819:Voriconazole