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2009 OMIG, Abstract 2

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Epidemiology of ulcerative keratitis in northern California.
B.H. Jeng1,2, D.C. Gritz1,3, A.B. Kumar1, D.S. Holsclaw1,4, T.C. Porco1,5, S.D. Smith2, J.P. Whitcher1,T.P. Margolis1, I.G. Wong1,6
1F.I. Proctor Foundation and the Dept. of Ophthalmology, Univ. of CA San Francisco, 2Cole Eye Institute, Cleveland Clinic, OH, 3Kaiser Permanente Foundation Hospitals-Oakland, Richmond, and 4Redwood City, CA, 5Dept. of Epi. and Biostatistics, Univ. of CA San Francisco, 6Dept. of Ophthalmology, Stanford Univ., Palo Alto, CA.

Purpose: To determine the incidence rate and associated factors for ulcerative keratitis in northern California from 1998-1999.
Methods: In this large population, retrospective incidence cohort study, all charts with diagnosis coding for corneal ulcer were reviewed. Incidence rates were calculated using a dynamic population model.
Results: Within the target population of 1,093,210 people, 302 patients developed ulcerative keratitis during the study period. The incidence of ulcerative keratitis was 27.6 per 100,000 person-years (95% CI 24.6-30.9).   The incidence of corneal ulceration in contact lens-wearers was 130.4 per 100,000 person-years (95% CI 111.3-151.7) with an odds ratio of 9.33 (95% CI, 7.43-11.7; p<0.0001) compared to non-contact lens wearers who had an incidence of ulcerative keratitis of 14.0 per 100,000 person-years (11.7-16.6). Seven of 2,944 known HIV-infected people developed ulcerative keratitis, with five being contact lens-wearers. The incidence of corneal ulceration HIV-positive patients was 238.1 per 100,000 person-years (95% CI 95.7-490.5) with an odds ratio of 8.84 (95% CI, 4.17-18.8; p=0.0001) compared to HIV-negative patients who had an incidence of ulcerative keratitis of 27.1 per 100,000 person-years (95% CI 24.1-30.3).
Conclusions:  The incidence of corneal ulceration in this study is higher than previously reported. This higher incidence may be due to the higher prevalence of contact lens wear, as contact lens wear remains a significant risk factor for the development of ulcerative keratitis. 
Support: Heed Ophthalmic Fellowship (BHJ), Direct Community Benefit Investment Grant, Kaiser Research Foundation Institute (DCG), That Man May See (BHJ, TCP), and Research to Prevent Blindness Senior Scientific Investigator Award (TPM).

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