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Prognostic factors affecting visual outcome in Acanthamoeba keratitis
Elmer Y Tu1, Charlotte E Joslin, Joel Sugar
1University of Illinois at Chicago, Department of Ophthalmology, Chicago, Illinois, USA.
Ophthalmology
|June 24, 2008
Summary
Deep stromal involvement and ring infiltrates in Acanthamoeba keratitis (AK) predict worse visual outcomes. Early corneal staging is crucial for identifying patients needing aggressive treatment for better results.
Area of Science:
- Ophthalmology
- Microbiology
Background:
- Acanthamoeba keratitis (AK) is a serious microbial infection of the cornea.
- Identifying factors predicting poor visual outcomes is essential for timely and effective management.
Purpose of the Study:
- To determine clinical and demographic factors associated with worse visual outcomes in Acanthamoeba keratitis.
- To identify prognostic indicators for visual prognosis in AK patients.
Main Methods:
- Retrospective case-control study involving 65 patients (72 eyes) diagnosed with AK.
- Data collected included demographics, clinical characteristics, treatment, and visual outcomes.
- Logistic regression analysis was used to identify factors associated with visual outcomes worse than 20/25 or requiring penetrating keratoplasty (PKP).
Main Results:
- Deep stromal involvement and ring infiltrates at presentation were significantly associated with worse visual outcomes (OR, 10.27).
- Microbiologic or confocal microscopy confirmed AK in most cases.
- While symptom duration predicted disease stage, it did not reliably predict final visual outcome.
Conclusions:
- Corneal disease staging via slit-lamp examination at presentation is a strong predictor of visual outcomes in AK.
- These findings can guide more aggressive medical or surgical interventions for at-risk patients.
- Patient-reported symptom duration was not a reliable predictor of final visual results in this cohort.
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