Age-related Clinical Analysis of Infectious Keratitis in Two Tertiary Centers

ABSTRACT

PURPOSE: To evaluate the age-related risk factors, clinical manifestations, and prognosis in infectious keratitis. METHODS: Records of patients with infectious keratitis who visited one of the two tertiary medical centers at Jeolla-do from January 2000 to December 2007 were reviewed. Risk factors depending on patient age distribution standardized over and under the age of 60 were reviewed retrospectively by analyzing sex, age, previous history of trauma, systemic disease, previous ocular disease, causative organism and treatment. RESULTS: A total of 757 patients (757 eyes) visited either one of the two tertiary medical centers. The mean age was 58.2+/-18.0 (4 to 93) years, and patients included 437 males (57.7%), and 320 females (42.3%). The most common risk factor among all age groups was trauma, especially due to vegetable matter. The second most frequent risk factor among the younger patients was contact lens use (19.2%), and common risk factors among the elderly were previous ocular disease (20.0%), systemic disease (15.5%), and ocular surgery (9.7%). The most prevalent causative organisms among all age groups were Gram-positive bacteria, in particular Staphylococcus epidermidis. Elderly patients had a higher frequency of corneal perforation than did younger patients. In addition, elderly patients had a worse prognosis and more often required surgical treatment. CONCLUSIONS: Infectious keratitis has more severe clinical manifestations and complications and a worse prognosis in elderly than in younger patients. Elderly patients have more diverse risk factors. Prevention should aim at avoiding ocular trauma, especially by vegetable matter, and at controlling ocular surface diseases, such as exposure keratitis and bullous keratopathy.