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Author Spotlight: Studying Behavior of Acanthamoeba to Develop Targeted Strategies for Preventing Acanthamoeba Keratitis
07:33

Author Spotlight: Studying Behavior of Acanthamoeba to Develop Targeted Strategies for Preventing Acanthamoeba Keratitis

Published on: September 20, 2024

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Acanthamoeba keratitis in 194 patients: risk factors for bad outcomes and severe inflammatory complications

Nicole Carnt1,2,3, Dana Robaei3,4, Darwin C Minassian5

  • 1School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia.

The British Journal of Ophthalmology
|January 5, 2018
PubMed
Abstract

Insights

Prompt diagnosis and appropriate treatment are key for Acanthamoeba keratitis (AK) outcomes. Older age, delayed treatment, and prior corticosteroid use are risk factors for poor prognosis and severe inflammation in AK patients.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Acanthamoeba keratitis (AK) is a serious microbial eye infection.
  • Identifying risk factors for poor outcomes and severe inflammatory complications (SICs) is crucial for patient management.

Purpose of the Study:

  • To determine demographic and clinical features associated with poor outcomes in AK patients.
  • To identify independent risk factors for severe inflammatory complications (SICs) in AK.

Main Methods:

  • Retrospective audit of 194 AK cases at Moorfields Eye Hospital (2000-2012).
  • Defined poor outcomes (corneal perforation, keratoplasty, prolonged therapy, poor vision) and SICs (scleritis, stromal ring infiltrate).
  • Utilized multivariable analysis to identify independent risk factors.

Main Results:

  • 48% of patients experienced poor outcomes.
  • Poor outcomes linked to SICs, age >34, pre-AAT corticosteroids, and delayed AAT (>37 days).
  • SICs associated with age >34, pre-AAT corticosteroids, and prior herpes simplex virus (HSV) keratitis treatment.

Conclusions:

  • Prompt AK diagnosis and avoiding misdiagnosis (e.g., HSV keratitis) are vital.
  • Judicious corticosteroid use before AK exclusion is essential for good outcomes.
  • Older age is an unmodifiable risk factor potentially related to immune response differences.
Keywords:
contact lenscorneaepidemiologyinfectioninflammation

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