Microsporidia-Associated Anterior Uveitis After Keratoconjunctivitis

Area of Science:

• Ophthalmology
• Infectious Diseases
• Corneal Diseases

Background:

• Microsporidial keratoconjunctivitis (MKC) is an ocular infection.
• Uveitis can be a complication of MKC, presenting with keratic precipitates and anterior chamber inflammation.
• Understanding the clinical course and optimal management of uveitis secondary to MKC is crucial for patient outcomes.

Purpose of the Study:

• To delineate the clinical characteristics of uveitis associated with microsporidial keratoconjunctivitis (MKC).
• To evaluate the management strategies and outcomes for patients with MKC-related uveitis.
• To assess the impact of corticosteroid treatment on the resolution of uveitis in MKC patients.

Main Methods:

• Retrospective review of medical records for patients diagnosed with MKC between July 2016 and August 2021.
• Inclusion criteria: clinically diagnosed or microbiologically proven MKC with evidence of keratic precipitates (KPs) or anterior chamber cells.
• Exclusion criteria: microsporidial stromal keratitis and herpes simplex virus keratouveitis.

Main Results:

• Out of 2212 patients, 171 eyes (7.7%) exhibited KPs and/or anterior chamber cells, indicating uveitis.
• The mean age of affected patients was 43.8 years, with a male predominance (n=120).
• Resolution time was longer with topical corticosteroid use compared to lubricants alone for both KPs and superficial punctate keratitis (P=0.007 and P=0.01, respectively). Visual acuity significantly improved upon resolution (P < 0.0001).

Conclusions:

• Uveitis following MKC is typically self-limiting and often resolves without corticosteroid intervention.
• Caution is advised when using steroids in patients with active corneal lesions due to potential delays in resolution.
• Non-steroidal management appears effective for MKC-associated uveitis, with visual recovery being favorable.