EPIDEMIOLOGY, RISK FACTORS, ETIOLOGIES AND CLINICAL OUTCOMES OF INFECTIOUS KERATITIS IN A REFERRAL CENTER IN TUNISIA, NORTH AFRICA

To investigate clinical features, risk factors and microbiological profile of patients with infectious keratitis. 

Ophthalmology Department, University Hospital of Mahdia, Tunisia.

This is a retrospective study. We collected epidemiological, microbiological and clinical outcomes data from medical records of patients with infectious keratitis hospitalized over 7 years from January 2016 to December 2022.

84 patients were collected (84 eyes). The mean age was 61 years, male to female ratio was 1.47. The most common risk factor was ocular surface diseases (OSD) (45.1%). Culture was obtained for 67 patients (79.8%) and was positive in only 14 eyes. Bacteria was isolated in 11 patients, fungi in 2 patients and acanthamoeba in 1 patient. After appropriate medical treatment, successfully keratitis healing was observed in 67 patients (79.8%) and 9 eyes (10.7%) required surgical intervention. Complications were reported in 14 patients (16.7%). Corneal perforation was the most common complication, occurring in 10.7% of cases. Therapeutic failure was associated with the presence of complication and the depth of stromal infiltrate (p<0.001 and p=0.025 respectively). Contact lens wearers and patients with poor visual acuity, larger corneal defect and complications at the initial presentation are more likely to have poorer final visual outcomes (p=0.021; p=0.001; p=0.031 and p=0.023 respectively).

In this study, the most common risk factor of infectious keratitis was OSD.  Final visual prognosis depends on the visual acuity, the size of the keratitis and the presence of complications at the initial presentation.