Abstract
Purpose: To describe clinical characteristics of Acanthamoeba keratitis from the Acanthamoeba –Fungal keratitis study.
Methods: The Acanthamoeba-Fungal keratitis study demonstrated that a significant number of co-infections do occur. Forty cases of Acanthamoeba were identified in the study; 19 of these did not have a co-infection. The observations regarding demographics, evolution of the disease, clinical presentations, clinical features etc., in this subgroup were catalogued and analysed.
Results: Except for one, all others were non-contact lens users. The clinical presentations, evolution of the various stages of Acanthamoeba keratitis, particularly with regard to duration, were noted to be substantially different from what is recorded in the literature. The staged evolution that is characteristically defined and used clinically to suspect Acanthamoeba was not observed. Epitheliitis and perineuritis were rarely observed. The most common presentation was stromal disease.
Conclusions: The clinical presentation of Acanthamoeba keratitis in non-contact lens wearers varies considerably from the observations made in contact lens related Acanthamoeba keratitis. Routine incorporation of non-nutrient agar in all cases of stromal keratitis - irrespective of the clinical presentation - would significantly improve identification of Acanthamoeba keratitis in non-contact lens wearers. Identification of more such cases using similar protocols would provide greater clarity in establishing the clinical features.
Keywords
Acanthamoeba, Acanthamoeba-Fungal keratitis study, Clinical features, Non-contact lens, lens