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Risk factors for low vision related functioning in the Mycotic Ulcer Treatment Trial: a randomised trial comparing natamycin with voriconazole
Risk factors for low vision related functioning in the Mycotic Ulcer Treatment Trial: a randomised trial comparing natamycin with voriconazole BRITISH JOURNAL OF OPHTHALMOLOGY Rose-Nussbaumer, J., Prajna, N., Krishnan, T., Mascarenhas, J., Rajaraman, R., Srinivasan, M., Raghavan, A., Oldenburg, C. E., O'Brien, K. S., Ray, K. J., Porco, T. C., McLeod, S. D., Acharya, N. R., Keenan, J. D., Lietman, T. M., Mycotic Ulcer Treatment Trial Grp 2016; 100 (7): 929-932Abstract
The Mycotic Ulcer Treatment Trial I (MUTT I) was a double-masked, multicentre, randomised controlled trial, which found that topical natamycin is superior to voriconazole for the treatment of filamentous fungal corneal ulcers. In this study, we determine risk factors for low vision-related quality of life in patients with fungal keratitis.The Indian visual function questionnaire (IND-VFQ) was administered to MUTT I study participants at 3 months. Associations between patient and ulcer characteristics and IND-VFQ subscale score were assessed using generalised estimating equations.323 patients were enrolled in the trial, and 292 (90.4%) completed the IND-VFQ at 3 months. Out of a total possible score of 100, the average VFQ score for all participants was 81.3 (range 0-100, SD 23.6). After correcting for treatment arm, each logMAR line of worse baseline visual acuity in the affected eye resulted in an average 1.2 points decrease on VFQ at 3 months (95% CI -1.8 to 0.6, p<0.001). Those who required therapeutic penetrating keratoplasty had an average of 25.2 points decrease on VFQ after correcting for treatment arm (95% CI -31.8 to -18.5, p<0.001). Study participants who were unemployed had on average 28.5 points decrease on VFQ (95% CI -46.9 to -10.2, p=0.002) after correcting for treatment arm.Monocular vision loss from corneal opacity due to fungal keratitis reduced vision-related quality of life. Given the relatively high worldwide burden of corneal opacity, improving treatment outcomes of corneal infections should be a public health priority.Clinicaltrials.gov Identifier: NCT00996736.
View details for DOI 10.1136/bjophthalmol-2015-306828
View details for Web of Science ID 000380747000011
View details for PubMedID 26531051
View details for PubMedCentralID PMC4965324