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. 2024 Jan;49(1):39-45.
doi: 10.1080/02713683.2023.2269322. Epub 2024 Jan 3.

A Comparison of Culture Results and Visual Acuity in Contact Lens Related Microbial Keratitis

Jenna N Hart  1 , Ming-Chen Lu  1 , Breanna M Tracey  1 , Keith D Miller  1 , Paul R Lephart  2 , Shahzad I Mian  1 , Maria A Woodward  1   3
Affiliations

A Comparison of Culture Results and Visual Acuity in Contact Lens Related Microbial Keratitis

Jenna N Hart et al. Curr Eye Res. 2024 Jan.

Abstract

Purpose: Evaluate the effect of corneal and contact lens-related (CLR) culture results on visual acuity (VA) in patients with microbial keratitis (MK).

Methods: MK patients with corneal and CLR cultures were identified in the University of Michigan electronic health record from August 2012 to April 2022. Test results were classified as laboratory-positive or laboratory-negative. Linear regression was used to examine trends of VA and associations between changes in VA (differences of VA at 90-day and baseline VA) and corneal and CLR culture results, after adjustment for baseline VA. One-sample t-tests were used to test if the slope estimates were different from zero.

Results: MK patients (n = 50) were on average 49 years old (standard deviation = 20.9), 56% female, and 90% White. Positive corneal and CLR cultures were reported in 60% and 64% of patients, respectively, and 38% reported both. The agreement rate between corneal and CLR culture results was 30% (n = 15/50). LogMAR VA improved over time in patients with positive corneal and CLR cultures (Estimate=-0.19 per 10-day increase, p = 0.002), and in those with negative corneal and positive CLR cultures (Estimate= -0.17 per 10-day increase, p = 0.004). Compared to patients with negative corneal and CLR cultures, there was a trend toward improvement in VA for patients with positive corneal and CLR cultures (Estimate=-0.68, p = 0.068), and those with negative corneal and positive CLR cultures (Estimate= -0.74, p = 0.059), after adjusting for baseline VA.

Conclusions: Positive CLR cultures are associated with significant improvement in VA over time. These additional cultures can provide guidance on appropriate antimicrobial selection, especially when corneal cultures are negative.

Keywords: Contact lens; corneal ulcer; microbial keratitis; microbiology; visual acuity.

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Figures

Figure 1.
Figure 1.
Line plots represent trends of visual acuity (VA) by corneal and contact lens-related culture results. Patients who had less than 5 VAs measured were excluded from the analysis. Trends of VAs for each patient were estimated using separate linear regression models (gray lines). Black lines display average intercepts and average slope estimates from the linear regression models.
See this image and copyright information in PMC

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