Ocular Microbiology and Immunology Group
Back to OMIG Main Page

< Previous | 2023 Agenda and Abstracts | Next >

2023 OMIG Abstract

Vision-Related Quality of Life Outcomes in Patients Treated for Filamentous Fungal Keratitis in the CLAIR Trial

Alejandro Arboleda^1,2, NV Prajna³, N Radhakrishnan³, Prajna Lalitha³, Revathi Rajaraman¹, Sarah Abdelrahman¹, Benjamin Arnold¹, Thomas M Lietman¹, Jennifer Rose-Nussbaumer<sup>1,2

1</sup>Dept of Ophthalmology and Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, CA; ²Byers Eye Institute, Dept of Ophthalmology, Stanford University, Palo Alto, CA; ³Aravind Eye Care System, Madurai, India

Purpose: To analyze vision-related quality of life in patients with fungal keratitis treated with topical antifungal medications and adjuvant crosslinking in the Cross-Linking Assisted Infection Reduction (CLAIR) trial.

Methods: Study participants were randomized to one of four treatment combinations: (1) topical natamycin 5%, (2) topical natamycin 5% plus CXL, (3) topical amphotericin 0.15%, and (4) topical amphotericin 0.15% plus CXL. All participants responded to the Indian visual function questionnaire (IND-VFQ) at the baseline visit and 3 months after enrollment. Responses were averaged within four subscales (mobility, activity limitation, psychosocial impact, and visual function). Scores were compared between the acute phase of infection and after treatment. A linear regression was then performed to compare IND-VFQ results between the four arms.

Results: IND-VFQ scores improved in patients three months after initiating treatment compared to baseline (P<0.01). Participants treated with amphotericin had a VFQ score 2.6 points (95% CI, -6.90-12.10) higher than those treated with natamycin (P=0.59). Participants treated with CXL had an average VFQ score 4.2 points (95% CI, -5.43-13.70) higher than those treated with medication only (P=0.29). Subscale analysis did not show significant differences between treatment groups.

Conclusions: All patients reported improved vision-related quality of life after treatment of fungal keratitis. Treatment with natamycin and amphotericin B produced similar results. Primary adjunctive CXL did not benefit patients with respect to vision-related quality of life in fungal keratitis patients. These results reflected primary results of CLAIR regarding microbiological cure, infiltrate and/or scar size, percent epithelialization, and frequency of adverse events.

Disclosure: N (Arboleda, Prajna, Radhakrishnan, Lalitha, Abdelrahman, Arnold); S (Lietman, Rose-Nussbaumer)

Support: This work was supported in part by an unrestricted grant from Research to Prevent Blindness (RPB), National Eye Institute (NEI): center grant P30-EY026877 (Stanford), UG1 EY030417 (Rose-Nussbaumer), UG1 EY028518 (Rose-Nussbaumer), K23 EY025025 (Rose-Nussbaumer).

< Previous | 2023 Agenda and Abstracts | Next >