# Improving Outcomes Assessment for Microbial Keratitis

> **NIH NIH K23** · JOHNS HOPKINS UNIVERSITY · 2024 · $224,134

## Abstract

ABSTRACT
The overarching research goal of this K23 Mentored Career Development Award is to improve outcomes
assessment for microbial keratitis (MK), or infectious corneal ulceration. MK affects 2 million people per year
and causes significant harm to vision and quality of life. Meaningful measurement of MK for clinical and
research purposes remains challenging. Traditional clinical assessments of MK severity and response to
treatment are subjective and imprecise, making it difficult to compare efficacy of treatments in clinical research
studies due to low reproducibility and increased sample size requirements. Prior MK clinical trials have used
outcome metrics such as best spectacle-corrected visual acuity which are not disease-specific and may fail to
capture key information about corneal damage caused by MK. These measurement limitations reduce the
quality and impact of MK research. To date, most large-scale prospective randomized trials in MK have failed
to demonstrate clinically meaningful or statistically significant differences in treatment response between
groups. Single-center MK studies can also lack applicability to other healthcare settings due to differences in
patient characteristics and microbial distributions across populations. Developing more objective, reproducible,
clinically relevant, and generalizable outcome metrics and predictors for MK would enhance the clinical
relevance and statistical power of future multicenter MK studies. New imaging modalities such as Scheimpflug
tomography and anterior segment optical coherence tomography (ASOCT) can provide objective, precise,
reproducible, and clinically relevant assessments of corneal structure, but these modalities have not been
critically evaluated for MK clinical care or research using prospective studies. This application proposes to
conduct a prospective cohort study of MK patients at Johns Hopkins. We will collect detailed clinical and
microbiologic data and perform serial multimodal imaging using slit lamp photography, Scheimpflug
tomography, and ASOCT over 6 months. Aim 1 will compare the reproducibility and concordance of ultrasound
pachymetry, Scheimpflug tomography, and ASOCT for objective quantification of corneal thinning in MK. Aim 2
will evaluate Scheimpflug densitometry as a means of objectively quantifying longitudinal changes in corneal
scar density in MK. Aim 3 will assess whether certain early anatomic or clinical features can improve prediction
of subsequent visual outcomes in MK and whether these predictors are applicable across different MK
populations and infection subgroups, indicating the suitability of these novel outcome metrics for use in
collaborative multicenter clinical trials. This proposal will provide the candidate with the advanced training and
research experience needed to become an expert in clinical trials methodology and an independently funded
clinician-scientist in the field of cornea and external diseases. The candidate proposes a compre...

## Key facts

- **NIH application ID:** 10818549
- **Project number:** 5K23EY032988-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Nakul Shekhawat
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $224,134
- **Award type:** 5
- **Project period:** 2022-06-01 → 2027-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10818549

## Citation

> US National Institutes of Health, RePORTER application 10818549, Improving Outcomes Assessment for Microbial Keratitis (5K23EY032988-03). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10818549. Licensed CC0.

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