Features of etiological factors, clinical course, and incidence of complications of bacterial keratitis in patients with type 2 diabetes mellitus under martial law in Ukraine

Background. Bacterial keratitis (BK) is a common and serious infectious eye condition that poses a threat to visual function. Type 2 diabetes mellitus (T2DM) increases the risk of developing BK, as evidenced by a higher incidence of eye infections in patients with diabetes. Under the conditions of martial law in Ukraine, access to timely ophthalmological care is limited, which worsens the clinical course and complicates the treatment of BK in patients with T2DM. Modern methods, including optical coherence tomography (OCT), allow assessment of the morphofunctional state of the cornea and monitoring treatment dynamics. Objective: to investigate the features of etiological factors, clinical course, and the incidence of complications of bacterial keratitis in patients with type 2 diabetes mellitus under martial law in Ukraine. Materials and methods. Fifty-seven patients (57 eyes) with bacterial keratitis and T2DM were observed. Etiology, clinical features, visual acuity, and corneal OCT parameters were analyzed at baseline and during follow-up, within up to 3 months. Statistical analysis was performed using ANOVA, χ², and other tests with a significance level of p < 0.05. Results. The most frequent etiological factors were improper contact lens use (28.07 %), traumatic corneal injury by foreign bo­dies (22.81 %), dry eye syndrome (17.54 %), and chemical injuries (10.53 %). A gradual and significant improvement in visual acuity was noted: uncorrec­ted visual acuity increased 5-fold, and best-corrected visual acuity increased 4-fold (p < 0.001). According to OCT data, there was a significant decrease in corneal thickness (by 22 %), stromal thickness (by 25 %), and thickness, width, and area of an infiltrate (by 86–91 %) over 3 months of treatment (p < 0.001). The most common complications were corneal opacities (17.54 %), vascularization (12.28 %), and anterior uveitis (8.77 %). Conclusions. In patients with type 2 diabetes mellitus, bacterial keratitis is most commonly associated with contact lens use and corneal trauma. Significant improvement in visual function and corneal morphological parameters was observed during treatment. These findings highlight the importance of timely diagnosis and adequate therapy of BK in patients with T2DM, especially under conditions of limited access to medical care.