J Korean Ophthalmol Soc.  2018 Mar;59(3):209-216. 10.3341/jkos.2018.59.3.209.

Clinical Aspects and Treatment Outcomes of Moraxella keratitis

• Song YY
• Bang S
• Lee TE
• Kang WS
• You IC

• KMID: 2406954
• DOI: http://doi.org/10.3341/jkos.2018.59.3.209

Abstract

PURPOSE
To analyze the clinical presentation, predisposing risk factors, and evaluate the treatment outcomes of Moraxella keratitis.
METHODS
A retrospective analysis was conducted of 12 culture positive cases of Moraxella keratitis from hospital records between March 2001 and November 2015 at a tertiary hospital to identify and analyze its risk factors, causative microbial organisms, clinical features, and therapeutic outcomes.
RESULTS
The mean patient age was 68 years (range, 46-86). The most common cause of keratitis was trauma (six eyes, 50.0%), and half of these patients had diabetes mellitus (three patients, 25.0%). Two patients (16.6%) were previously treated with penetrating keratoplasty. The locations of keratitis involved the central (50.0%) and paracentral (50.0%) regions. Round-shaped corneal infiltration was found in seven eyes (58.3%), and irregular-shaped infiltration was found in five eyes (41.7%). Hypopyon was observed in five eyes (41.7%). All Moraxella isolates were susceptible to aminoglycosides and fluoroquinolones. The isolates from three patients were resistant to trimethoprim/sulfamethoxazole. The mean complete epithelial healing time was 32.4 days. The final visual acuity was 20/1,000 or less in seven eyes (58.3%). Three eyes developed corneal perforations and eventually underwent evisceration.
CONCLUSIONS
In the Republic of Korea, Moraxella keratitis frequently occurs in eyes with trauma. The treatment response is very slow and has a poor visual outcome; thus, a long period of antibiotic therapy is necessary.

Keyword

Moraxella keratitis; Predisposing factor; Trauma; Treatment outcome

MeSH Terms

Aminoglycosides
Causality
Corneal Perforation
Diabetes Mellitus
Fluoroquinolones
Hospital Records
Humans
Keratitis*
Keratoplasty, Penetrating
Moraxella*
Republic of Korea
Retrospective Studies
Risk Factors
Tertiary Care Centers
Treatment Outcome
Visual Acuity
Aminoglycosides
Fluoroquinolones

Figure

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  Figure 1. Representative slit-lamp photographs of Moraxella keratitis. (A) Anterior segment photograph shows small pacacentral type corneal ulceration (Case 2). His initial visual acuity was 20/500. He was well treated with topical moxifloxacin, and his final visual acuity was 20/25. (B) Anterior segment photograph shows large central type corneal ulceration with a 0.5 mm height of hypopyon (Case 4). His initial visual acuity was light perception. The lesion was well healed with topical ceftazidime and moxifloxacin, but the opacity remained and his final visual acuity was light perception.

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