Regarding the use of topical corticosteroids in bacterial keratitis, the Steroids for Corneal Ulcers Trial (SCUT) demonstrated which of the following findings?
- A Topical prednisolone phosphate improved final visual acuity in all bacterial ulcers
- B Topical steroids reduced scarring but increased risk of perforation
- C Topical prednisolone phosphate did not improve outcomes overall and was harmful in Nocardia infections ✓
- D Topical steroids should never be used in any bacterial corneal ulcer
Correct answer: C. Topical prednisolone phosphate did not improve outcomes overall and was harmful in Nocardia infections
Explanation
SCUT showed topical prednisolone phosphate started 48 hours after antibiotics did not improve outcomes at 3 months overall. Post-hoc analysis suggested possible benefit in severe central ulcers but harm in Nocardia keratitis. Steroids are not routinely recommended in bacterial keratitis and should be avoided until infection is controlled. The trial did not show benefit across all ulcers.
Reference: AAO BCSC Section 8: External Disease and Cornea, 2022-2023 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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