Acanthamoeba keratitis in the last decade. What have we learned?

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Acanthamoeba keratitis (AK) is a severe corneal infection with potential for irreversible vision loss.
• Increasing contact lens use correlates with rising AK incidence.
• The COVID-19 pandemic introduced unique challenges to managing infectious diseases.

Purpose of the Study:

• To analyze the epidemiology, clinical presentation, treatment, and outcomes of AK over 10 years.
• To assess the impact of the COVID-19 pandemic on AK diagnosis and management.
• To provide insights into the varied presentations and effective treatments for AK.

Main Methods:

• Retrospective case series analysis of 13 patients with AK.
• Review of clinical data, microbiological diagnoses, and treatment responses.
• Comparison of diagnostic trends during pre-pandemic, pandemic, and post-pandemic periods.

Main Results:

• A diagnostic gap in AK was observed during the COVID-19 pandemic.
• All patients were contact lens wearers; common initial misdiagnoses included herpetic keratitis.
• Presentations included pseudo-dendrite and annular infiltrate patterns.
• Treatment with 0.02% chlorhexidine and 0.1% propamidine eye drops led to visual acuity improvement in 10 out of 13 cases.

Conclusions:

• AK management requires awareness of its diverse clinical presentations.
• The pandemic impacted AK diagnosis, highlighting the need for vigilance.
• Combined chlorhexidine and propamidine therapy shows efficacy in improving visual outcomes for AK patients.