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Deep Learning for the Detection of Corneal Perforation on Anterior-Segment Optical Coherence Tomography in Microbial Keratitis.

Bioengineering (Basel, Switzerland)·2026
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Detection and Measurement of Hypopyon on Slit Lamp Examination Versus Anterior Segment Optical Coherence Tomography.

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medRxiv : the preprint server for health sciences·2026
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Updated: Jan 11, 2026

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Anatomic Biomarkers Predict Poor Presenting Visual Acuity in Infectious Keratitis.

Shruti Anant1, Kamini Reddy1, Jordan Shuff1

  • 1Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Clinical Ophthalmology (Auckland, N.Z.)
|November 17, 2025
PubMed
Summary

Infectious keratitis in India is linked to poor vision, especially with bacterial or polymicrobial infections. Anatomic features like large epithelial defects and hypopyon are key predictors of severe outcomes.

Keywords:
biomarkerscorneal infectioncorneal ulcerrisk stratification

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Public Health

Background:

  • Infectious keratitis is a primary cause of corneal blindness globally, with a higher prevalence in developing nations.
  • Identifying risk factors for poor visual acuity is crucial for targeted interventions in affected populations.

Purpose of the Study:

  • To investigate the risk factors associated with poor presenting visual acuity in a rural Indian population suffering from infectious keratitis.
  • To analyze demographic, clinical, and anatomical variables predicting severe visual impairment.

Main Methods:

  • A cross-sectional study was conducted involving 667 patients aged 16 years and above with active infectious keratitis.
  • Data on demographics, clinical presentation, and slit-lamp examination findings were collected.
  • Binomial logistic regression was used to identify independent predictors of best-corrected visual acuity (BCVA) ≤20/200.

Main Results:

  • Nearly 75% of patients presented with visual acuity ≤20/200.
  • Independent risk factors for poor visual acuity included older age, bacterial and polymicrobial infections, larger epithelial defects, posterior stromal infiltrate, endothelial plaque, central infiltrate location, and hypopyon.
  • Travel distance and time to presentation were not independently associated with poor visual acuity.

Conclusions:

  • Anatomical features such as large epithelial defects, deep stromal infiltrates, endothelial plaque, central location, and hypopyon are significant predictors of poor visual acuity in infectious keratitis.
  • These anatomical findings can serve as valuable biomarkers for identifying eyes at risk of severe outcomes and for future clinical trial design.