Kathryn Richdale1, Dawn Y Lam2, Heidi Wagner3, Aaron B Zimmerman4, Beth T Kinoshita5, Robin Chalmers6, Luigina Sorbara7, Loretta Szczotka-Flynn8, Usha Govindarajulu1, G Lynn Mitchell4. 1. College of Optometry State University of New York, New York City, New York, United States. 2. Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, California, United States. 3. College of Optometry, The Ohio State University, Columbus, Ohio, United States 4College of Optometry, Nova Southeastern University, Fort Lauderdale, Florida, United States. 4. College of Optometry, The Ohio State University, Columbus, Ohio, United States. 5. College of Optometry, Pacific University, Forest Grove, Oregon, United States. 6. Clinical Trial Consultant, Atlanta, Georgia, United States. 7. School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada. 8. University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, Ohio, United States.
Abstract
PURPOSE: The purpose of this study was to assess risk factors associated with soft contact lens (SCL)-related corneal infiltrative events (CIEs). METHODS: This was a single-visit, case-control study conducted at five academic centers in North America. Cases were defined as current SCL wearers with a symptomatic CIE. For each case, three age- and sex-matched controls were enrolled. Subjects completed the Contact Lens Risk Survey (CLRS), a standardized scripted medical interview, supplied a recent health history, and underwent an ocular examination. Microbial culturing of the ocular surface, SCL, and lens storage case was conducted for all cases and one of the three matched controls. Univariate and multivariate logistic regression modeling were used to assess the risk of developing a CIE. RESULTS: Thirty cases and 90 controls 13 to 31 years of age completed the study. Corneal infiltrative event diagnosis included contact lens-associated red eye, infiltrative keratitis, and contact lens peripheral ulcer. Subjects with symptomatic CIEs were more likely to harbor substantial levels of gram-negative bioburden on the ocular surface and contact lens. Significant risk factors for developing a CIE were overnight wear of SCLs, use of multipurpose solution, rinsing SCLs with water, lens storage case older than 6 months, previous "red eye" event, use of ocular drops in the past week, and illness during the past week. CONCLUSIONS: This pilot study demonstrated feasibility of enrolling a representative pool of SCL wearers with an untreated, symptomatic CIE and assessing CIE risk factors by using standardized methods. A larger sample size is needed to determine relationships between patient-reported behaviors and exposures, microbial bioburden, and CIE development.
PURPOSE: The purpose of this study was to assess risk factors associated with soft contact lens (SCL)-related corneal infiltrative events (CIEs). METHODS: This was a single-visit, case-control study conducted at five academic centers in North America. Cases were defined as current SCL wearers with a symptomatic CIE. For each case, three age- and sex-matched controls were enrolled. Subjects completed the Contact Lens Risk Survey (CLRS), a standardized scripted medical interview, supplied a recent health history, and underwent an ocular examination. Microbial culturing of the ocular surface, SCL, and lens storage case was conducted for all cases and one of the three matched controls. Univariate and multivariate logistic regression modeling were used to assess the risk of developing a CIE. RESULTS: Thirty cases and 90 controls 13 to 31 years of age completed the study. Corneal infiltrative event diagnosis included contact lens-associated red eye, infiltrative keratitis, and contact lens peripheral ulcer. Subjects with symptomatic CIEs were more likely to harbor substantial levels of gram-negative bioburden on the ocular surface and contact lens. Significant risk factors for developing a CIE were overnight wear of SCLs, use of multipurpose solution, rinsing SCLs with water, lens storage case older than 6 months, previous "red eye" event, use of ocular drops in the past week, and illness during the past week. CONCLUSIONS: This pilot study demonstrated feasibility of enrolling a representative pool of SCL wearers with an untreated, symptomatic CIE and assessing CIE risk factors by using standardized methods. A larger sample size is needed to determine relationships between patient-reported behaviors and exposures, microbial bioburden, and CIE development.
Authors: Aaron B Zimmerman; Kathryn Richdale; Gladys Lynn Mitchell; Beth T Kinoshita; Dawn Y Lam; Heidi Wagner; Luigina Sorbara; Robin L Chalmers; Sarah A Collier; Jennifer R Cope; Maya M Rao; Michael J Beach; Jonathan S Yoder Journal: Cornea Date: 2017-08 Impact factor: 2.651
Authors: Cecilia Chao; Lakshmi Akileswaran; Jessica N Cooke Bailey; Mark Willcox; Russell Van Gelder; Carol Lakkis; Fiona Stapleton; Kathryn Richdale Journal: Invest Ophthalmol Vis Sci Date: 2018-12-03 Impact factor: 4.799