Epidemiology of ulcerative keratitis in Northern California

• Published in: Archives of ophthalmology (1960) Vol. 128; no. 8; p. 1022
• Main Authors: Jeng, Bennie H, Gritz, David C, Kumar, Abha B, Holsclaw, Douglas S, Porco, Travis C, Smith, Scott D, Whitcher, John P, Margolis, Todd P, Wong, Ira G
• Format: Journal Article
• Language: English
• Published: United States 01-08-2010
• Subjects: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; California - epidemiology; Child; Child, Preschool; Contact Lenses - utilization; Corneal Ulcer - epidemiology; Corneal Ulcer - microbiology; Cross-Sectional Studies; Databases, Factual; Eye Infections, Bacterial - epidemiology; Eye Infections, Bacterial - microbiology; Eye Infections, Fungal - epidemiology; Eye Infections, Fungal - microbiology; Female; HIV Seropositivity; Humans; Incidence; Infant; Infant, Newborn; Male; Middle Aged; Retrospective Studies; Risk Factors; Sex Distribution; Young Adult; California
• ISSN: 1538-3601
• DOI: 10.1001/archophthalmol.2010.144

To determine the incidence and associated risk factors for ulcerative keratitis in northern California.
In this large-population, retrospective, cohort study, all medical records with diagnosis coding for corneal ulcers during a consecutive 12-month period were reviewed. Incidence rates were calculated using a dynamic population model. Multivariate relative risk regression was conducted to evaluate potential risk factors for ulcerative keratitis.
Within the target population of 1 093 210 patients, 302 developed ulcerative keratitis. The incidence of ulcerative keratitis was 27.6 per 100 000 person-years (95% confidence interval, 24.6-30.9). The incidence of corneal ulceration in contact lens wearers was 130.4 per 100 000 person-years (95% confidence interval, 111.3-151.7), with an adjusted relative risk of 9.31 (7.42-11.7; P < .001) compared with 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 2944 people known to be infected with human immunodeficiency virus developed ulcerative keratitis, with 5 being contact lens wearers. The incidence of ulcerative keratitis in human immunodeficiency virus-positive patients was 238.1 per 100 000 person-years (95% confidence interval, 95.7-490.5), with an odds ratio of 9.31 (7.42-11.7; P < .001) compared with human immunodeficiency virus-negative patients, who had an incidence of ulcerative keratitis of 27.1 per 100 000 person-years (24.1-30.3).
The incidence of ulcerative keratitis in this population is higher than previously reported. This may be owing to the increasing prevalence of contact lens wear.