Prediction of Visual Acuity in Patients With Microbial Keratitis.
Journal
Cornea
ISSN: 1536-4798
Titre abrégé: Cornea
Pays: United States
ID NLM: 8216186
Informations de publication
Date de publication:
01 Feb 2023
01 Feb 2023
Historique:
received:
31
01
2022
accepted:
16
07
2022
pmc-release:
01
02
2024
pubmed:
19
10
2022
medline:
3
1
2023
entrez:
18
10
2022
Statut:
ppublish
Résumé
The purpose of this study was to predict visual acuity (VA) 90 days after presentation for patients with microbial keratitis (MK) from data at the initial clinical ophthalmic encounter. Patients with MK were identified in the electronic health record between August 2012 and February 2021. Random forest (RF) models were used to predict 90-day VA < 20/40 [visual impairment (VI)]. Predictors evaluated included age, sex, initial VA, and information documented in notes at presentation. Model diagnostics are reported with 95% confidence intervals (CIs) for area under the curve (AUC), misclassification rate, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). One thousand seven hundred ninety-one patients were identified. The presenting logMAR VA was on average 0.86 (Snellen equivalent and standard deviation = 20/144 ± 12.6 lines) in the affected or worse eye, and 43.6% with VI. VI at 90-day follow-up was present in the affected eye or worse eye for 26.9% of patients. The RF model for predicting 90-day VI had an AUC of 95% (CI: 93%-97%) and a misclassification rate of 9% (7%-12%). The percent sensitivity, specificity, PPV, and NPV were 86% (80%-91%), 92% (89%-95%), 81% (74%-86%), and 95% (92%-97%), respectively. Older age, worse presenting VA, and more mentions of "penetrating keratoplasty" and "bandage contact lens" were associated with increased probability of 90-day VI, whereas more mentions of "quiet" were associated with decreased probability of 90-day VI. RF modeling yielded good sensitivity and specificity to predict VI at 90 days which could guide clinicians about the risk of poor vision outcomes for patients with MK.
Identifiants
pubmed: 36256452
doi: 10.1097/ICO.0000000000003129
pii: 00003226-202302000-00014
pmc: PMC9805475
mid: NIHMS1824701
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
217-223Subventions
Organisme : NEI NIH HHS
ID : R01 EY031033
Pays : United States
Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
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