Clinical Manifestation and Risk Factors Associated With Remission in Patients With Filamentary Keratitis

Purpose: This study investigated the clinical manifestation and risk factors associated with remission in filamentary keratitis. Design: Retrospective, interventional, comparative case series. Methods: We retrospectively reviewed the medical records of 116 patients with filamentary keratitis diagnosed and treated between January 2012 and December 2018. We investigated the 5 causative factors including brain lesion, dry eye syndrome, autoimmune disease, ocular surgery or injury, and other conditions; treatment methods and duration; and remission status, and analyzed the risk factors associated with remission. Results: The mean age of the patients was 56.9 ± 19.1 years and the mean follow-up duration was 14.9 ± 22.8 months. The most common underlying condition associated with filamentary keratitis was identified as a brain lesion (36.2%), followed by dry eye syndrome (30.2%) and autoimmune disease (24.1%). A comparison of remission rates among the causative factors revealed that cases associated with brain lesions had significantly lower remission rates (33.3%) than those associated with other causative factors (>60%) (P = .001). After adjustment for sex, age, diabetes mellitus, and hypertension, the treatment failure rate in patients affected by brain lesions was 6.602-fold higher than that associated without brain lesion (P = .001). The treatment method–dependent differences in the remission rate were observed in brain lesion and dry eye syndrome (P = .041 and P = .005, respectively). Conclusions: The most common condition leading to filamentary keratitis was a brain lesion, followed by dry eye syndrome and autoimmune disease. The treatment failure rate was statistically significantly low only in patients with filamentary keratitis associated with brain lesions.