| Peer-Reviewed

Bacterial Keratitis in Type 1 Diabetic Patients: Course and Consequences

Received: 26 May 2021    Accepted: 8 June 2021    Published: 15 June 2021
Views:       Downloads:
Abstract

The purpose was to define the peculiarities of the course and consequences of bacterial keratitis in patients with type 1 diabetes mellitus (DM1) depending on the stage of its severity. Methods. 34 DM1 patients (34 eyes) with bacterial keratitis whose initial bacteriological examination revealed pathogen sensitivity to the antibiotic ofloxacin participated in this study. All patients were treated topically with ofloxacin, antiseptics, repairing agents, antioxidants, mydriatics, artificial tears and systemically with anti-inflammatory agents. Patients were divided into two groups according to the severity of bacterial keratitis at the first visit. Research methods were as follows: visual acuity, tonometry, slit-lamp biomicroscopy of anterior and posterior eye segments, fluorescein dye test, non-contact corneal esthesiometry, anterior eye OCT and bacteriological studies. Results. Compared to the stage I, DM1 patients with stage II severity bacterial keratitis showed higher degree of pericorneal injection, larger and deeper corneal ulcer defect, deeper corneal infiltration and edema, higher mean corneal sensitivity threshold at all time point of the study, p<0.05. DM1 patients with stage II severity bacterial keratitis were more prone for longer duration of the disease and worse consequences. Therefore, on day 24 in 33.3% diabetic patients with stage II severity bacterial keratitis corneal ulcer was not found to be healed. Conclusions. Course and consequences of bacterial keratitis in type 1 diabetes mellitus patients depend on the stage of severity of bacterial keratitis.

Published in International Journal of Ophthalmology & Visual Science (Volume 6, Issue 2)
DOI 10.11648/j.ijovs.20210602.19
Page(s) 115-121
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Diabetes Mellitus, Bacterial Keratitis, Course of Bacterial Keratitis Course, Consequences of Bacterial Keratitis

References
[1] Peleg AY, Weerarathna T, McCarthy JS, Davis TM (2007) Common infections in diabetes: pathogenesis, management and relationship to glycaemic control. Diabetes Metable Res Rev 23 (1): 3-13. https://doi.org/10.1002/dmrr.682
[2] Shah BR, Hux JE (2003) Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care 26: 510–513.
[3] Kanter JE, Bornfeldt KE (2016) Impact of Diabetes Mellitus. Arterioscler Thromb Vasc Biol 36 (6): 1049-1053. https://doi:10.1161/ATVBAHA.116.307302
[4] Recio C, Oguiza A, Lazaro I, Mallavia B, Egido J, Gomez-Guerrero C (2014) Suppressor of cytokine signaling 1-derived peptide inhibits Janus kinase/signal transducers and activators of transcription pathway and improves inflammation and atherosclerosis in diabetic mice. Arterioscler Thromb Vasc Biol 34 (9): 1953-6190. https://doi:10.1161/ATVBAHA.114.304144.
[5] Gray SP, Di Marco E, Kennedy K, Chew P, Okabe J, El-Osta A, Calkin AC, Biessen EA, Touyz RM, Cooper ME, Schmidt HH, Jandeleit-Dahm KA (2015) Reactive Oxygen Species Can Provide Atheroprotection via NOX4-Dependent Inhibition of Inflammation and Vascular Remodeling. Arterioscler Thromb Vasc Biol 36 (2): 295-307. https://doi:10.1161/ATVBAHA.115.307012.
[6] Chang YS, Tai MC, Ho CH, Chu CC, Wang JJ, Tseng SH, Jan RL (2020) Risk of Corneal Ulcer in Patients with Diabetes Mellitus: A Retrospective Large-Scale Cohort Study. Sci Rep 30; 10 (1): 7388. https://doi.org/10.1038/s41598-020-64489-0.
[7] Badawi AE, Moemen D, El-Tantawy NL (2017) Epidemiological, clinical and laboratory findings of infectious keratitis at Mansoura Ophthalmic Center, Egypt. Int J Ophthalmol 18; 10 (1): 61-67. https://doi.org/10.18240/ijo.2017.01.10
[8] Inoue H, Suzuki T, Inoue T, Hattori T, Nejima R, Todokoro D, Hoshi S, Eguchi H, Miyamoto H, Ohashi Y (2015). Clinical Characteristics and Bacteriological Profile of Moraxella Keratitis. Cornea 34 (9): 1105-1109. https://doi.org/10.1097/ICO.0000000000000470
[9] Wang B, Yang S, Zhai HL, Zhang YY, Cui CX, Wang JY, Xie LX (2018) A comparative study of risk factors for corneal infection in diabetic and non-diabetic patients. Int J Ophthalmol 18; 11 (1): 43-47. https://doi.org/10.18240/ijo.2018.01.08
[10] Almizel A, Alsuhaibani FA, Alkaff AM, Alsaleh AS, Al-Mansouri SM (2019) Bacterial Profile and Antibiotic Susceptibility Pattern of Bacterial Keratitis at a Tertiary Hospital in Riyadh. Clin Ophthalmol 20; 13: 2547-2552. https://doi.org/10.2147/OPTH.S223606
[11] Vieira-Potter VJ, Karamichos D, Lee DJ (2016) Ocular Complications of Diabetes and Therapeutic Approaches. Biomed Res Int 2016: 3801570. https://doi.org/10.1155/2016/3801570
[12] Ormerod LD, Hertzmark E, Gomez DS, Stabiner RG, Schanzlin DJ, Smith RE (1987) Epidemiology of microbial keratitis in southern California. A multivariate analysis. Ophthalmology 94 (10): 1322-1333. https://doi.org/10.1016/s0161-6420(87)80019-2
[13] Al-Mujaini A, Al-Kharusi N, Thakral A, Wali UK (2009) Bacterial keratitis: perspective on epidemiology, clinico-pathogenesis, diagnosis and treatment. Sultan Qaboos Univ Med J 9 (2): 184-195.
[14] Zagon IS, Sassani JW, Carroll MA, McLaughlin PJ (2010) Topical application of naltrexone facilitates reepithelialization of the cornea in diabetic rabbits. Brain Res Bull 81: 248–255. https://doi.org/10.1016/j.brainresbull.2009.10.009
[15] Kaji Y (2005) Prevention of diabetic keratopathy. Br J Ophthalmol 89 (3): 254-255. https://doi.org/10.1136/bjo.2004.055541
[16] Cisarik-Fredenburg P (2001) Discoveries in research on diabetic keratopathy. Optometry 72 (11): 691-704.
[17] Sánchez-Thorin JC (1998) The cornea in diabetes mellitus. Int Ophthalmol Clin 38 (2): 19-36.
[18] Schultz RO, Van Horn DL, Peters MA, Klewin KM, Schutten WH (1981) Diabetic keratopathy. Trans Am Ophthalmol Soc 79: 180-199.
[19] Ljubimov AV (2017) Diabetic complications in the cornea. Vision Res 139: 138-152. https://doi.org/10.1016/j.visres.2017.03.002
[20] Dyck PJ, Dyck PJB (1999) Diabetic polyneuropathy: section III. In: Dyck PJ, Thomas PK (ed) Diabetic Neuropathy, 2nd edn. Saunders, Philadelphia, pp. 255–278.
[21] Boulton AJ, Malik RA, Arezzo JC, Sosenko JM (2004) Diabetic somatic neuropathies. Diabetes Care 27 (6): 1458-1486. https://doi.org/10.2337/diacare.27.6.1458
[22] Zavoloka OV, Besditko PA, Lukhanin OO (2019) Efficacy of a novel non-contact corneal esthesiometer in assessing the neurotrophic status of the cornea in type I diabetic patients with bacterial keratitis. J Ophthalmol (Ukraine) 6: 29-33. http://doi.org/10.31288/oftalmolzh201962933
[23] Bikbova G, Oshitari T, Baba T, Bikbov M, Yamamoto S (2018) Diabetic corneal neuropathy: clinical perspectives. Clin Ophthalmol 25; 12: 981-987. https://doi.org/10.2147/OPTH.S145266
[24] Roszkowska AM, Licitra C, Tumminello G, Postorino EI, Colonna MR, Aragona P (2020) Corneal nerves in diabetes -The role of the in vivo corneal confocal microscopy of the subbasal nerve plexus in the assessment of peripheral small fiber neuropathy. Surv Ophthalmol 19: S0039-6257 (20) 30133-8. https://doi.org/10.1016/j.survophthal.2020.09.003
[25] Nielsen NV (1978) Corneal sensitivity and vibratory perception in diabetes mellitus. Acta Ophthalmol (Copenh) 56 (3): 406-411. https://doi.org/10.1111/j.1755-3768.1978.tb05693.x
[26] Rosenberg ME, Tervo TM, Immonen IJ, Müller LJ, Grönhagen-Riska C, Vesaluoma MH (2000) Corneal structure and sensitivity in type 1 diabetes mellitus. Invest Ophthalmol Vis Sci 41 (10): 2915-2921.
[27] Saito J, Enoki M, Hara M, Morishige N, Chikama T, Nishida T (2003) Correlation of corneal sensation, but not of basal or reflex tear secretion, with the stage of diabetic retinopathy. Cornea 22 (1): 15-18. https://doi.org/10.1097/00003226-200301000-00004
[28] Cousen P, Cackett P, Bennett H, Swa K, Dhillon B (2007) Tear production and corneal sensitivity in diabetes. J Diabetes Complications 21 (6): 371-373. https://doi.org/10.1016/j.jdiacomp.2006.05.008
[29] Tavakoli M, Kallinikos PA, Efron N, Boulton AJ, Malik RA (2007) Corneal sensitivity is reduced and relates to the severity of neuropathy in patients with diabetes. Diabetes Care 30 (7): 1895-1897. https://doi.org/10.2337/dc07-0175
[30] De Cillà S, Ranno S, Carini E, Fogagnolo P, Ceresara G, Orzalesi N, Rossetti LM (2009) Corneal subbasal nerves changes in patients with diabetic retinopathy: an in vivo confocal study. Invest Ophthalmol Vis Sci 50 (11): 5155-5158. https://doi.org/10.1167/iovs.09-3384
[31] Zhivov A, Winter K, Hovakimyan M, Peschel S, Harder V, Schober HC, Kundt G, Baltrusch S, Guthoff RF, Stachs O (2013) Imaging and quantification of subbasal nerve plexus in healthy volunteers and diabetic patients with or without retinopathy. PLoS One 8 (1): e52157. https://doi.org/10.1371/journal.pone.0052157
[32] Malik RA, Kallinikos P, Abbott CA, van Schie CH, Morgan P, Efron N, Boulton AJ (2003) Corneal confocal microscopy: a non-invasive surrogate of nerve fibre damage and repair in diabetic patients. Diabetologia 46 (5): 683-688. https://doi.org/10.1007/s00125-003-1086-8
[33] Kallinikos P, Berhanu M, O'Donnell C, Boulton AJ, Efron N, Malik RA (2004) Corneal nerve tortuosity in diabetic patients with neuropathy. Invest Ophthalmol Vis Sci 45 (2): 418-422. https://doi.org/10.1167/iovs.03-0637
[34] Mocan MC, Durukan I, Irkec M, Orhan M (2006) Morphologic alterations of both the stromal and subbasal nerves in the corneas of patients with diabetes. Cornea 25 (7): 769-773. https://doi.org/10.1097/01.ico.0000224640.58848.54
[35] Szalai E, Deák E, Módis L Jr, Németh G, Berta A, Nagy A, Felszeghy E, Káposzta R, Malik RA, Csutak A (2016) Early Corneal Cellular and Nerve Fiber Pathology in Young Patients With Type 1 Diabetes Mellitus Identified Using Corneal Confocal Microscopy. Invest Ophthalmol Vis Sci 57 (3): 853-858. https://doi.org/10.1167/iovs.15-18735
Cite This Article
  • APA Style

    Olesia Zavoloka, Pavlo Bezditko. (2021). Bacterial Keratitis in Type 1 Diabetic Patients: Course and Consequences. International Journal of Ophthalmology & Visual Science, 6(2), 115-121. https://doi.org/10.11648/j.ijovs.20210602.19

    Copy | Download

    ACS Style

    Olesia Zavoloka; Pavlo Bezditko. Bacterial Keratitis in Type 1 Diabetic Patients: Course and Consequences. Int. J. Ophthalmol. Vis. Sci. 2021, 6(2), 115-121. doi: 10.11648/j.ijovs.20210602.19

    Copy | Download

    AMA Style

    Olesia Zavoloka, Pavlo Bezditko. Bacterial Keratitis in Type 1 Diabetic Patients: Course and Consequences. Int J Ophthalmol Vis Sci. 2021;6(2):115-121. doi: 10.11648/j.ijovs.20210602.19

    Copy | Download

  • @article{10.11648/j.ijovs.20210602.19,
      author = {Olesia Zavoloka and Pavlo Bezditko},
      title = {Bacterial Keratitis in Type 1 Diabetic Patients: Course and Consequences},
      journal = {International Journal of Ophthalmology & Visual Science},
      volume = {6},
      number = {2},
      pages = {115-121},
      doi = {10.11648/j.ijovs.20210602.19},
      url = {https://doi.org/10.11648/j.ijovs.20210602.19},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20210602.19},
      abstract = {The purpose was to define the peculiarities of the course and consequences of bacterial keratitis in patients with type 1 diabetes mellitus (DM1) depending on the stage of its severity. Methods. 34 DM1 patients (34 eyes) with bacterial keratitis whose initial bacteriological examination revealed pathogen sensitivity to the antibiotic ofloxacin participated in this study. All patients were treated topically with ofloxacin, antiseptics, repairing agents, antioxidants, mydriatics, artificial tears and systemically with anti-inflammatory agents. Patients were divided into two groups according to the severity of bacterial keratitis at the first visit. Research methods were as follows: visual acuity, tonometry, slit-lamp biomicroscopy of anterior and posterior eye segments, fluorescein dye test, non-contact corneal esthesiometry, anterior eye OCT and bacteriological studies. Results. Compared to the stage I, DM1 patients with stage II severity bacterial keratitis showed higher degree of pericorneal injection, larger and deeper corneal ulcer defect, deeper corneal infiltration and edema, higher mean corneal sensitivity threshold at all time point of the study, p Conclusions. Course and consequences of bacterial keratitis in type 1 diabetes mellitus patients depend on the stage of severity of bacterial keratitis.},
     year = {2021}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Bacterial Keratitis in Type 1 Diabetic Patients: Course and Consequences
    AU  - Olesia Zavoloka
    AU  - Pavlo Bezditko
    Y1  - 2021/06/15
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijovs.20210602.19
    DO  - 10.11648/j.ijovs.20210602.19
    T2  - International Journal of Ophthalmology & Visual Science
    JF  - International Journal of Ophthalmology & Visual Science
    JO  - International Journal of Ophthalmology & Visual Science
    SP  - 115
    EP  - 121
    PB  - Science Publishing Group
    SN  - 2637-3858
    UR  - https://doi.org/10.11648/j.ijovs.20210602.19
    AB  - The purpose was to define the peculiarities of the course and consequences of bacterial keratitis in patients with type 1 diabetes mellitus (DM1) depending on the stage of its severity. Methods. 34 DM1 patients (34 eyes) with bacterial keratitis whose initial bacteriological examination revealed pathogen sensitivity to the antibiotic ofloxacin participated in this study. All patients were treated topically with ofloxacin, antiseptics, repairing agents, antioxidants, mydriatics, artificial tears and systemically with anti-inflammatory agents. Patients were divided into two groups according to the severity of bacterial keratitis at the first visit. Research methods were as follows: visual acuity, tonometry, slit-lamp biomicroscopy of anterior and posterior eye segments, fluorescein dye test, non-contact corneal esthesiometry, anterior eye OCT and bacteriological studies. Results. Compared to the stage I, DM1 patients with stage II severity bacterial keratitis showed higher degree of pericorneal injection, larger and deeper corneal ulcer defect, deeper corneal infiltration and edema, higher mean corneal sensitivity threshold at all time point of the study, p Conclusions. Course and consequences of bacterial keratitis in type 1 diabetes mellitus patients depend on the stage of severity of bacterial keratitis.
    VL  - 6
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Department of Ophthalmology, Kharkiv National Medical University, Kharkiv, Ukraine

  • Department of Ophthalmology, Kharkiv National Medical University, Kharkiv, Ukraine

  • Sections