Purpose: To report the prevalence of ocular morbidity in patients with treated multibacillary Hansen's disease (HD) using modern ophthalmic diagnostic techniques in a rural community endemic for HD.
Design: Cross-sectional, observation study.
Participants: All patients with multibacillary HD who had completed their multidrug therapy and who resided in 4 defined geographical areas in Vellore, Tamil Nadu, India.
Methods: All participants underwent a complete eye examination that included slit-lamp examination, esthesiometry, gonioscopy, applanation tonometry, and dilated fundus examination, including a stereobiomicroscopic examination of the fundus at an ophthalmic center set up for that purpose. Glaucoma suspects underwent automated perimetry using a Humphrey Field Analyzer (Humphrey Instruments, San Leandro, CA).
Main Outcome Measures: The prevalence of various ocular disease parameters were reported as mean value with 95% confidence interval. The difference of disease prevalence between various leprosy groups was compared using an unpaired t test. The association between eye symptoms and potentially sight-threatening complications was analyzed using the chi-square test.
Results: Three hundred eighty-six of the 446 patients with multibacillary HD residing in the defined areas were evaluated. Four patients (1.04%; 95% confidence interval [CI], 0.0%-2.0%) were bilaterally blind; 33 (8.55%; 95% CI, 5.8%-11.3%) had unilateral blindness. Mean intraocular pressure was 12 mmHg (standard deviation, 4.1 mmHg), and prevalence of glaucoma was 3.6% (95% CI, 1.8%-5.5%). Potentially sight-threatening (PST) pathologic features (corneal anesthesia, lagophthalmos, uveitis, scleritis, and advanced glaucoma) were present in 10.4% (95% CI, 7.4%-13.4%) of patients. Significant cataracts occurred 3 times more frequently in those with polar lepromatous leprosy. The odds ratio for PST pathology in the presence of patient-reported symptoms (pain, redness, inability to close eye, burning, and irritation) was 2.9 (95% CI, 1.34-6.26).
Conclusions: Patients who have completed treatment for multibacillary HD continue to have significant ocular morbidity. A history of specific eye symptoms can be the basis for referral by field staff.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ophtha.2009.04.021 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Misdiagnosis of Leprosy with Severe Reversal Reaction as Psoriatic Arthritis: A Case Report and Literature Review.
Clin Cosmet Investig Dermatol
January 2025
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.
Introduction: Leprosy is a chronic granulomatous disease caused by and . Meanwhile, leprosy reactions are immunologically mediated episodes of acute or subacute inflammation that occur during the chronic course of the disease. Leprosy and leprosy reaction have a wide range of clinical manifestations, including those resembling psoriatic arthritis.
View Article and Find Full Text PDFAn alternative multidrug regimen for multibacillary Hansen's disease: a case report.
J Med Case Rep
December 2024
Division of Infectious Diseases, Denver Health Medical Center, Denver, CO, USA.
Background: Leprosy (Hansen's disease) is an infectious disease most common in resource-limited countries caused by the acid-fast bacilli Mycobacterium leprae and Mycobacterium lepromatosis that frequently affects the skin and peripheral nerves. Prompt diagnosis and treatment with multidrug therapy is crucial to reduce disease transmission and sequelae, which include nerve function impairment, ocular injury, and stigmatizing physical deformities. Traditional treatment of multibacillary leprosy consists of 12-24 months of multidrug therapy with dapsone, rifampin, and clofazimine.
View Article and Find Full Text PDFBedaquiline Monotherapy for Multibacillary Leprosy.
N Engl J Med
December 2024
From the Research Division, Instituto Lauro de Souza Lima, Bauru (J.B., P.S.R.), and Fundação de Dermatologia Tropical e Venereologia Alfredo da Matta, Manaus (P.F.B.R.) - both in Brazil; the Department of Health and Human Services, Health Resources and Services Administration, Health Systems Bureau, National Hansen's Disease Program, Laboratory Research Branch, Baton Rouge, LA (L.A., R.T.); Translational Medicine and Early Development Statistics (S.Y.), WAVE Team (Z.A., S.R.C., S.K., D.M., J.A.P., M.W.), Janssen Research and Development, San Diego, CA; Janssen Global Public Health, Janssen Research and Development, Titusville, NJ (N.B., R.D.A.); and Janssen Global Public Health, Janssen Pharmaceutica, Beerse, Belgium (E.E., N.L., B.R.).
Background: Standard multidrug therapy for leprosy may be associated with severe side effects, which add to the stigma and discrimination that affect persons with the disease. In addition, the threat posed by drug-resistant leprosy shows the need for alternative drug combinations and shorter, safer regimens of multidrug therapy.
Methods: In this open-label, proof-of-concept study conducted in Brazil, we assigned patients with previously untreated multibacillary leprosy to receive bedaquiline monotherapy for 8 weeks.
Leprosy.
Nat Rev Dis Primers
November 2024
Leiden University Center of Infectious Diseases (LUCID), Leiden University Medical Center, Leiden, The Netherlands.
Leprosy, a neglected tropical disease, causes significant morbidity in marginalized communities. Before the COVID-19 pandemic, annual new case detection plateaued for over a decade at ~200,000 new cases. The clinical phenotypes of leprosy strongly parallel host immunity to its causative agents Mycobacterium leprae and Mycobacterium lepromatosis.
View Article and Find Full Text PDFClinical relevance and prognostic impact of the classification between multibacillary and paucibacillary forms of cutaneous tuberculosis: A 24-year retrospective multicenter study.
Ann Dermatol Venereol
December 2024
Infectious and Tropical Diseases Department, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, AP-HP, Paris, France; Sorbonne University, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
Objectives: Cutaneous tuberculosis (CTB) may be over-diagnosed due to imprecise diagnostic criteria or overlooked where mycobacterial investigations are negative. We evaluated the distinction between multibacillary and paucibacillary forms of CTB, as well as drug resistance and cure rates according to the results of mycobacterial investigations.
Methods: We included retrospectively all patients diagnosed with CTB from 1995 to 2018 in two hospitals in Paris.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!