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Corneal infection in mucosal scarring disorders and Sjögren's syndrome
L D Ormerod1, L P Fong, C S Foster
1Cornea Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston.
Abstract:
We reviewed 69 episodes of microbial keratitis occurring over an 11-year period in 56 patients with a mucosal scarring disorder or Sjögren's syndrome. Gram-positive bacterial isolates were the most common cause of infection, and accounted for almost all cases in patients with Sjögren's syndrome. Trichiasis (cicatricial pemphigoid), topical corticosteroids, bandage contact lenses, and corneal surgery were the main predisposing factors in the development of the corneal infection. In patients with ocular cicatricial pemphigoid, infection was much less common after chemotherapeutic control had been achieved. Recurrent infections were relatively frequent. There was a high rate of major complications, particularly in microbial keratitis complicating Sjögren's syndrome.
Insights
Microbial keratitis, an eye infection, frequently affects patients with Sjögren
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Mucosal scarring disorders and Sjögren's syndrome increase ocular infection risk.
- Microbial keratitis is a serious complication in these patients.
Purpose of the Study:
- To investigate the epidemiology and predisposing factors of microbial keratitis in patients with mucosal scarring disorders or Sjögren's syndrome.
- To identify common pathogens and complications associated with these infections.
Main Methods:
- Retrospective review of 69 microbial keratitis episodes over 11 years in 56 patients.
- Analysis of patient demographics, predisposing factors, causative organisms, and outcomes.
Main Results:
- Gram-positive bacteria were the most common cause, especially in Sjögren's syndrome patients.
- Key predisposing factors included trichiasis, topical corticosteroids, bandage contact lenses, and corneal surgery.
- Ocular cicatricial pemphigoid patients had fewer infections after chemotherapy.
- Recurrent infections and major complications were frequent, particularly with Sjögren's syndrome.
Conclusions:
- Microbial keratitis poses a significant threat to patients with Sjögren's syndrome and mucosal scarring disorders.
- Prompt management of predisposing factors and underlying conditions is crucial to prevent severe outcomes.