Anatomic Biomarkers Predict Poor Presenting Visual Acuity in Infectious Keratitis.

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.