The Asia Cornea Society Infectious Keratitis Study: A Prospective Multicenter Study of Infectious Keratitis in Asia

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Infectious keratitis is a significant cause of visual impairment globally.
• Understanding regional variations in demographics, risk factors, and causative agents is crucial for effective management.

Purpose of the Study:

• To conduct a comprehensive survey of infectious keratitis across Asia.
• To identify key demographics, risk factors, microbiological profiles, and treatment outcomes.

Main Methods:

• A prospective, nonrandomized clinical study involving 13 study centers and 30 sub-centers.
• Standardized data collection and microbiological protocols were employed over 12-18 months.
• Subjects were followed for up to 6 months to assess visual acuity and surgical outcomes.

Main Results:

• 6626 eyes of 6563 subjects were analyzed, with males predominating.
• Trauma (34.7%) and contact lens wear (10.7%) were the most common risk factors.
• Bacterial (38.0%) and fungal (32.7%) keratitis were equally prevalent, with Fusarium, Pseudomonas aeruginosa, and Aspergillus flavus as leading pathogens. Over 50% experienced moderate visual impairment, and corneal transplant failure was high (46%).

Conclusions:

• Infectious keratitis demographics and risk factors vary across Asian countries, with male gender and trauma being common.
• Bacterial and fungal infections are similarly frequent, necessitating broad-spectrum or targeted antimicrobial approaches.
• Visual recovery is often poor, and corneal transplantation for active infection carries a substantial risk of graft failure.