Optimal infiltration depth threshold for low-temperature plasma ablation in fungal keratitis

Abstract Purpose To identify prognostic factors and their optimal thresholds influencing the treatment outcome of low-temperature plasma ablation therapy in patients with fungal keratitis (FK). Methods The clinical information of fifty-one patients with FK treated with low-temperature plasma ablatio...

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Main Authors: Zhengwei Yang, Miaomiao Liu, Guihua Yang, Lijin Wen, Juan Yang, Hanqiao Li, Zhiwen Xie, Xie Fang, Shunrong Luo, Xianwen Xiao, Yuan Lin, Huping Wu
Format: Article
Language:English
Published: SpringerOpen 2025-07-01
Series:Journal of Ophthalmic Inflammation and Infection
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Online Access:https://doi.org/10.1186/s12348-025-00501-w
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author Zhengwei Yang
Miaomiao Liu
Guihua Yang
Lijin Wen
Juan Yang
Hanqiao Li
Zhiwen Xie
Xie Fang
Shunrong Luo
Xianwen Xiao
Yuan Lin
Huping Wu
author_facet Zhengwei Yang
Miaomiao Liu
Guihua Yang
Lijin Wen
Juan Yang
Hanqiao Li
Zhiwen Xie
Xie Fang
Shunrong Luo
Xianwen Xiao
Yuan Lin
Huping Wu
author_sort Zhengwei Yang
collection DOAJ
description Abstract Purpose To identify prognostic factors and their optimal thresholds influencing the treatment outcome of low-temperature plasma ablation therapy in patients with fungal keratitis (FK). Methods The clinical information of fifty-one patients with FK treated with low-temperature plasma ablation at Xiamen Eye Center from 2018 to 2024 was retrospectively analyzed. Patients were categorized into Responder and Non-Responder groups based on their response to treatment: complete/partial healing (Responder group) versus disease progression or need for additional surgery (Non-Responder group). Differences in demographic and clinical characteristics between the two groups were compared. Additionally, exact univariate and multivariate logistic regression were performed to identify prognostic factors. Lastly, receiver operating characteristic (ROC) curve analysis was utilized to determine the cut-off value for significant prognostic factors. Results Among the 51 patients, 37 were classified in the Responder group and 14 in the Non-Responder group. Univariate analysis revealed significant differences in the presence of hypopyon (p = 0.038), ulcer size (p = 0.002), infiltration depth (p = 0.001), and paracentral ulcer location (p = 0.030) between the groups. Multivariate analysis identified infiltration depth (adjusted odds ratio [aOR] = 1.41, 95% CI: 1.05–1.91, p = 0.024) as the sole significant independent prognostic factor. ROC analysis demonstrated excellent discrimination ability for infiltration depth, with an area under the curve of 0.966. Finally, the optimal threshold for infiltration depth was determined to be 0.48, exhibiting a sensitivity of 92.86% and specificity of 91.89%. Conclusions Low-temperature plasma ablation represents an effective treatment for FK, with infiltration depth serving as a crucial prognostic indicator. The identified threshold provides valuable guidance for patient selection. Nonetheless, larger prospective studies are warranted to validate these findings.
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spelling doaj-art-53c2ee2398d54e75b8e78596d33136d72025-08-20T03:37:40ZengSpringerOpenJournal of Ophthalmic Inflammation and Infection1869-57602025-07-011511810.1186/s12348-025-00501-wOptimal infiltration depth threshold for low-temperature plasma ablation in fungal keratitisZhengwei Yang0Miaomiao Liu1Guihua Yang2Lijin Wen3Juan Yang4Hanqiao Li5Zhiwen Xie6Xie Fang7Shunrong Luo8Xianwen Xiao9Yuan Lin10Huping Wu11School of Medicine, Xiamen Eye Center and Eye Institute of Xiamen UniversitySchool of Medicine, Xiamen Eye Center and Eye Institute of Xiamen UniversityDepartment of Medical Ultrasonics, The third affiliated hospital of Zhengzhou universityDepartment of Ophthalmology, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science; Fujian Engineering and Research Center of Eye Regenerative Medicine; School of Medicine, Xiang’an Hospital of Xiamen University; Eye Institute of Xiamen University, Xiamen UniversitySchool of Medicine, Xiamen Eye Center and Eye Institute of Xiamen UniversitySchool of Medicine, Xiamen Eye Center and Eye Institute of Xiamen UniversitySchool of Medicine, Xiamen Eye Center and Eye Institute of Xiamen UniversitySchool of Medicine, Xiamen Eye Center and Eye Institute of Xiamen UniversitySchool of Medicine, Xiamen Eye Center and Eye Institute of Xiamen UniversitySchool of Medicine, Xiamen Eye Center and Eye Institute of Xiamen UniversitySchool of Medicine, Xiamen Eye Center and Eye Institute of Xiamen UniversitySchool of Medicine, Xiamen Eye Center and Eye Institute of Xiamen UniversityAbstract Purpose To identify prognostic factors and their optimal thresholds influencing the treatment outcome of low-temperature plasma ablation therapy in patients with fungal keratitis (FK). Methods The clinical information of fifty-one patients with FK treated with low-temperature plasma ablation at Xiamen Eye Center from 2018 to 2024 was retrospectively analyzed. Patients were categorized into Responder and Non-Responder groups based on their response to treatment: complete/partial healing (Responder group) versus disease progression or need for additional surgery (Non-Responder group). Differences in demographic and clinical characteristics between the two groups were compared. Additionally, exact univariate and multivariate logistic regression were performed to identify prognostic factors. Lastly, receiver operating characteristic (ROC) curve analysis was utilized to determine the cut-off value for significant prognostic factors. Results Among the 51 patients, 37 were classified in the Responder group and 14 in the Non-Responder group. Univariate analysis revealed significant differences in the presence of hypopyon (p = 0.038), ulcer size (p = 0.002), infiltration depth (p = 0.001), and paracentral ulcer location (p = 0.030) between the groups. Multivariate analysis identified infiltration depth (adjusted odds ratio [aOR] = 1.41, 95% CI: 1.05–1.91, p = 0.024) as the sole significant independent prognostic factor. ROC analysis demonstrated excellent discrimination ability for infiltration depth, with an area under the curve of 0.966. Finally, the optimal threshold for infiltration depth was determined to be 0.48, exhibiting a sensitivity of 92.86% and specificity of 91.89%. Conclusions Low-temperature plasma ablation represents an effective treatment for FK, with infiltration depth serving as a crucial prognostic indicator. The identified threshold provides valuable guidance for patient selection. Nonetheless, larger prospective studies are warranted to validate these findings.https://doi.org/10.1186/s12348-025-00501-wFungal keratitisLow-temperature plasma ablationPrognostic factorsInfiltration depthClinical outcomes
spellingShingle Zhengwei Yang
Miaomiao Liu
Guihua Yang
Lijin Wen
Juan Yang
Hanqiao Li
Zhiwen Xie
Xie Fang
Shunrong Luo
Xianwen Xiao
Yuan Lin
Huping Wu
Optimal infiltration depth threshold for low-temperature plasma ablation in fungal keratitis
Journal of Ophthalmic Inflammation and Infection
Fungal keratitis
Low-temperature plasma ablation
Prognostic factors
Infiltration depth
Clinical outcomes
title Optimal infiltration depth threshold for low-temperature plasma ablation in fungal keratitis
title_full Optimal infiltration depth threshold for low-temperature plasma ablation in fungal keratitis
title_fullStr Optimal infiltration depth threshold for low-temperature plasma ablation in fungal keratitis
title_full_unstemmed Optimal infiltration depth threshold for low-temperature plasma ablation in fungal keratitis
title_short Optimal infiltration depth threshold for low-temperature plasma ablation in fungal keratitis
title_sort optimal infiltration depth threshold for low temperature plasma ablation in fungal keratitis
topic Fungal keratitis
Low-temperature plasma ablation
Prognostic factors
Infiltration depth
Clinical outcomes
url https://doi.org/10.1186/s12348-025-00501-w
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