Incidence of ocular morbidity among multibacillary leprosy patients during a 2 year course of multidrug therapy

• Published in: British journal of ophthalmology Vol. 90; no. 5; pp. 568 - 573
• Main Authors: Daniel, E, ffytche, T J, Sundar Rao, P S S, Kempen, J H, Diener-West, M, Courtright, P
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.05.2006; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adult; Age Factors; Bacteriological Techniques; Biological and medical sciences; borderline lepromatous leprosy; Clinical Science - Extended Report; Drug Therapy, Combination; Eye Diseases - diagnosis; Eye Diseases - microbiology; eye manifestations; Female; Humans; Incidence; India; lepromatous leprosy; Leprostatic Agents - therapeutic use; leprosy; Leprosy - complications; Leprosy - drug therapy; Leprosy - microbiology; leprosy related ocular pathology; LROP; Male; MDT; Medical sciences; Miscellaneous; multibacillary; multidrug therapy; Ophthalmology; paucibacillary; PBLROP; potentially blinding leprosy related ocular pathology; Proportional Hazards Models; Prospective Studies; Risk Assessment; risk factors; Time Factors; India; Human; Skin disease; Ocular; Mycobacterial infection; Epidemiology; Morbidity; Incidence; Infection; Eye; Treatment; Bacteriosis; Multibacillary leprosy; Ophthalmology
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.2005.084913

Aim: To evaluate the incidence of and risk factors for ocular complications in multibacillary (MB) leprosy patients during their 2 year, fixed duration, multidrug therapy (MDT). Methods: Periodic eye examinations were conducted prospectively on a cohort of 301 consecutive newly diagnosed MB patients every 6 months during their 2 year course of MDT. Incidence of ocular pathology was calculated as the number of events per person year of event free follow up of patients who did not have the specific finding at baseline. Results: 292 (97%) patients had one or more follow up visits. The incidence of lagophthalmos was 1.2%/patient year (95% CI 0.5% to 2.8%); corneal opacity was 7.4%/patient year (95% CI 5.1% to 10.6%); uveal involvement was 5.1%/patient year (95% CI 3.3% to 7.8%), and cataract that reduced vision to 6/18 or less was seen in 4.3%/patient year (95% CI 2.7% to 6.9%) of patients. Overall, 23 individuals (5.8%/patient year, 95% CI 3.9 to 8.8) developed leprosy related potentially blinding pathology during the 2 years of MDT. Conclusions: Approximately 20% of patients with MB leprosy can be expected to develop ocular complications of leprosy during a 2 year course of MDT, many (11%) of which are potentially vision threatening. Ophthalmological monitoring to detect and treat ocular complications at defined intervals during MDT is indicated.