Literature DB >> 21987581

The steroids for corneal ulcers trial: study design and baseline characteristics.

Muthiah Srinivasan1, Jeena Mascarenhas, Revathi Rajaraman, Meenakshi Ravindran, Prajna Lalitha, David V Glidden, Kathryn J Ray, Kevin C Hong, Catherine E Oldenburg, Salena M Lee, Michael E Zegans, Stephen D McLeod, Thomas M Lietman, Nisha R Acharya.   

Abstract

OBJECTIVES: To provide comprehensive trial methods and baseline data for the Steroids for Corneal Ulcers Trial and to present epidemiological characteristics such as risk factors, causative organisms, and ulcer severity.
METHODS: Baseline data from a 1:1 randomized, placebo-controlled, double-masked clinical trial comparing prednisolone phosphate, 1%, with placebo as adjunctive therapy for the treatment of bacterial corneal ulcers. Eligible patients had a culture-positive bacterial corneal ulcer and had been taking moxifloxacin for 48 hours. The primary outcome for the trial is best spectacle-corrected visual acuity at 3 months from enrollment. This report provides comprehensive baseline data, including best spectacle-corrected visual acuity, infiltrate size, microbiological results, and patient demographics, for patients enrolled in the trial.
RESULTS: Of 500 patients enrolled, 97% were in India. Two hundred twenty patients (44%) were agricultural workers. Median baseline visual acuity was 0.84 logMAR (Snellen, 20/125) (interquartile range, 0.36-1.7; Snellen, 20/50 to counting fingers). Baseline visual acuity was not significantly different between the United States and India. Ulcers in India had larger infiltrate/scar sizes (P = .04) and deeper infiltrates (P = .04) and were more likely to be localized centrally (P = .002) than ulcers enrolled in the United States. Gram-positive bacteria were the most common organisms isolated from the ulcers (n = 366, 72%).
CONCLUSIONS: The Steroids for Corneal Ulcers Trial will compare the use of a topical corticosteroid with placebo as adjunctive therapy for bacterial corneal ulcers. Patients enrolled in this trial had diverse ulcer severity and on average significantly reduced visual acuity at presentation. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00324168.

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Year:  2011        PMID: 21987581      PMCID: PMC3830555          DOI: 10.1001/archophthalmol.2011.303

Source DB:  PubMed          Journal:  Arch Ophthalmol        ISSN: 0003-9950


  24 in total

1.  The effect of cortisone on experimental pseudomonas corneal ulcers.

Authors:  T SUIE; F W TAYLOR
Journal:  AMA Arch Ophthalmol       Date:  1956-07

2.  Comparison of antibiotic-only and antibiotic-steroid combination treatment in corneal ulcer patients: double-blinded randomized clinical trial.

Authors:  Jason Blair; William Hodge; Saeed Al-Ghamdi; Rita Balabanian; Beth Lowcock; Yi Irene Pan; Hesham Sherif; Tahra AlMahmoud; Dean Fergusson; Allan Slomovic
Journal:  Can J Ophthalmol       Date:  2011-02       Impact factor: 1.882

3.  Rationale for adjunctive topical corticosteroids in bacterial keratitis.

Authors:  Holly B Hindman; Sheel B Patel; Albert S Jun
Journal:  Arch Ophthalmol       Date:  2009-01

4.  Corticosteroid in experimentally induced Pseudomonas keratitis: failure of prednisolone to impair the efficacy of tobramycin and carbenicillin therapy.

Authors:  S D Davis; L D Sarff; R A Hyndiuk
Journal:  Arch Ophthalmol       Date:  1978-01

Review 5.  Indecision about corticosteroids for bacterial keratitis: an evidence-based update.

Authors:  Kirk R Wilhelmus
Journal:  Ophthalmology       Date:  2002-05       Impact factor: 12.079

6.  Bacterial keratitis: a prospective clinical and microbiological study.

Authors:  F Schaefer; O Bruttin; L Zografos; Y Guex-Crosier
Journal:  Br J Ophthalmol       Date:  2001-07       Impact factor: 4.638

7.  Global data on visual impairment in the year 2002.

Authors:  Serge Resnikoff; Donatella Pascolini; Daniel Etya'ale; Ivo Kocur; Ramachandra Pararajasegaram; Gopal P Pokharel; Silvio P Mariotti
Journal:  Bull World Health Organ       Date:  2004-12-14       Impact factor: 9.408

8.  Does in vitro susceptibility predict clinical outcome in bacterial keratitis?

Authors:  Aiyin Chen; Lalitha Prajna; Muthiah Srinivasan; Rajendran Mahalakshmi; John P Whitcher; Stephen McLeod; Thomas M Lietman; Nisha R Acharya
Journal:  Am J Ophthalmol       Date:  2008-01-22       Impact factor: 5.258

9.  Trends in the etiology of infectious corneal ulcers at the F. I. Proctor Foundation.

Authors:  Gita Varaprasathan; Kevin Miller; Thomas Lietman; John P Whitcher; Vicky Cevallos; Masao Okumoto; Todd P Margolis; Miao Yinghui; Emmett T Cunningham
Journal:  Cornea       Date:  2004-05       Impact factor: 2.651

10.  Bacterial keratitis: predisposing factors, clinical and microbiological review of 300 cases.

Authors:  T Bourcier; F Thomas; V Borderie; C Chaumeil; L Laroche
Journal:  Br J Ophthalmol       Date:  2003-07       Impact factor: 4.638

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  24 in total

1.  Early addition of topical corticosteroids in the treatment of bacterial keratitis.

Authors:  Kathryn J Ray; Muthiah Srinivasan; Jeena Mascarenhas; Revathi Rajaraman; Meenakshi Ravindran; David V Glidden; Catherine E Oldenburg; Catherine Q Sun; Michael E Zegans; Stephen D McLeod; Nisha R Acharya; Thomas M Lietman
Journal:  JAMA Ophthalmol       Date:  2014-06       Impact factor: 7.389

2.  Topical Corticosteroids in the Management of Bacterial Keratitis.

Authors:  Sonal S Tuli
Journal:  Curr Ophthalmol Rep       Date:  2013-12

3.  Relationship of in vitro susceptibility to moxifloxacin and in vivo clinical outcome in bacterial keratitis.

Authors:  Prajna Lalitha; Muthiah Srinivasan; P Manikandan; M Jayahar Bharathi; Revathi Rajaraman; Meenakshi Ravindran; Vicky Cevallos; Catherine E Oldenburg; Kathryn J Ray; Christine M Toutain-Kidd; David V Glidden; Michael E Zegans; Stephen D McLeod; Nisha R Acharya; Thomas M Lietman
Journal:  Clin Infect Dis       Date:  2012-03-23       Impact factor: 9.079

4.  Corticosteroids for bacterial keratitis: the Steroids for Corneal Ulcers Trial (SCUT).

Authors:  Muthiah Srinivasan; Jeena Mascarenhas; Revathi Rajaraman; Meenakshi Ravindran; Prajna Lalitha; David V Glidden; Kathryn J Ray; Kevin C Hong; Catherine E Oldenburg; Salena M Lee; Michael E Zegans; Stephen D McLeod; Thomas M Lietman; Nisha R Acharya
Journal:  Arch Ophthalmol       Date:  2011-10-10

5.  Visual recovery in treated bacterial keratitis.

Authors:  Muthiah Srinivasan; Jeena Mascarenhas; Revathi Rajaraman; Meenakshi Ravindran; Prajna Lalitha; Kathryn J Ray; Michael E Zegans; Nisha R Acharya; Thomas M Lietman; Jeremy D Keenan
Journal:  Ophthalmology       Date:  2014-03-05       Impact factor: 12.079

6.  Visual outcomes in treated bacterial keratitis: four years of prospective follow-up.

Authors:  Scott M McClintic; Namperumalsamy V Prajna; Muthiah Srinivasan; Jeena Mascarenhas; Prajna Lalitha; Revathi Rajaraman; Catherine E Oldenburg; Kieran S O'Brien; Kathryn J Ray; Nisha R Acharya; Thomas M Lietman; Jeremy D Keenan
Journal:  Invest Ophthalmol Vis Sci       Date:  2014-05-02       Impact factor: 4.799

7.  Improvement in corneal scarring following bacterial keratitis.

Authors:  S M McClintic; M Srinivasan; J Mascarenhas; D A Greninger; N R Acharya; T M Lietman; J D Keenan
Journal:  Eye (Lond)       Date:  2012-12-14       Impact factor: 3.775

8.  Association between cytotoxic and invasive Pseudomonas aeruginosa and clinical outcomes in bacterial keratitis.

Authors:  Durga S Borkar; Suzanne M J Fleiszig; Chelsia Leong; Prajna Lalitha; Muthiah Srinivasan; Avanti A Ghanekar; Connie Tam; Wing Y Li; Michael E Zegans; Stephen D McLeod; Thomas M Lietman; Nisha R Acharya
Journal:  JAMA Ophthalmol       Date:  2013-02       Impact factor: 7.389

9.  Pseudomonas aeruginosa keratitis: outcomes and response to corticosteroid treatment.

Authors:  Aileen Sy; Muthiah Srinivasan; Jeena Mascarenhas; Prajna Lalitha; Revathi Rajaraman; Meenakshi Ravindran; Catherine E Oldenburg; Kathryn J Ray; David Glidden; Michael E Zegans; Stephen D McLeod; Thomas M Lietman; Nisha R Acharya
Journal:  Invest Ophthalmol Vis Sci       Date:  2012-01-25       Impact factor: 4.799

10.  Moxifloxacin susceptibility mediates the relationship between causative organism and clinical outcome in bacterial keratitis.

Authors:  Catherine E Oldenburg; Prajna Lalitha; Muthiah Srinivasan; Palanisamy Manikandan; M Jayahar Bharathi; Revathi Rajaraman; Meenakshi Ravindran; Jeena Mascarenhas; Natalie Nardone; Kathryn J Ray; David V Glidden; Nisha R Acharya; Thomas M Lietman
Journal:  Invest Ophthalmol Vis Sci       Date:  2013-02-28       Impact factor: 4.799

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