India

Steroids for Corneal Ulcers Treatment (SCUT)

Infectious corneal ulcers are a major cause of vision loss worldwide. In South India, studies indicate that approximately half of corneal ulcers are bacterial, and there is evidence that this proportion is often higher in the United States and Europe. Clearance of the infectious agent is bacterial keratitis is usually successful, but patients are frequently left with poor visual outcomes. Scarring is thought to be largely responsible for this visual impairment, and some argue that treating bacterial corneal ulcers with adjunctive corticosteroids could reduce immune-mediated tissue damage and help improve clinical outcomes like visual acuity. The use of corticosteroids for bacterial keratitis has been extensively debated due to the potential negative effects of corticosteroids such as enhanced infection, corneal thinning, and corneal perforation. The Steroids for Corneal Ulcers Trial (SCUT) was a randomized controlled trial funded by the National Eye Institute (NEI) at the National Institutes of Health (NIH). In this trial, we compared corticosteroids as adjunctive treatment for bacterial corneal ulcers to placebo among patients treated with antibiotics. This project was a collaboration between the F. I. Proctor Foundation at UCSF, Dartmouth Medical School and Aravind Eye Hospitals in India. For more information, please see:
http://clinicaltrials.gov/ct2/show/NCT00324168