A case-control study ci; risk factors and clinical outcomes between fungal and bacterial keratitis
Purpose. Previous studies on fungal and bacterial keratitis were descriptive single case series analysis. We conducted a case-control study between fungal and bacterial keratilis to examine their risk factors and clinical outcomes. Methods. 29 consecutive cases of culture-positive fungal keratitis (cases) seen over a 5 year period were compared to 5! cases of culture-positive bacterial keratitis (controls). Using bacterial keratitis as the reference group, case-control odds ratios (OR) for predisposing factors and cohort relative risks (RR) for clinical outcomes associated with fungai keratitis were derived. Results. Compared to bacterial keratitis, fungal keratitis was significantly more likely to be associated with ocular trauma (OR= 2. 69, 95% confidence interval IT. 1. 06-6. 86) but significantly less likely to be associated with contact lens wear (OR=0. 16, 95% CI. 0. 04-0. 67) and preexisting ocular diseases (OR=0. 23, 95% Cl. 0. 07-0. 72). Fungal keratitis was more likely to perforate than bacterial keratitis, (RR=5. 28. 95% CI, i. 35-20. 66), and to require penetrating keratoplasiy (RR-5. 86, 95% CI, 2. 06-16. 69). Conclusions. Fungal keratitis appears more likely to result from ocular trauma, whereas bacterial keratitis is more likely to result from contact lens wear and preexisting ocular diseases. Fungal keratitis is more likely to result in perforation and require penetrating keratoplasty than bacterial keratitis.
Wong, TY; Ng, TP; Fong, KS; Tan, DTH
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