B Kettesy1, L Módis, T Komár, A Berta. 1. Department of Ophthalmology, University of Debrecen Medical and Health Science Centre, Ungarn. kettesyb@freemail.hu
Abstract
BACKGROUND: With increasing numbers of contact lens wearers, Acanthamoeba infections are also more frequent all over the world and also in Hungary. Despite improved diagnostic and therapeutic possibilities it can still cause serious visual loss. In this study the symptoms, signs, diagnostics and treatment options for Acanthamoeba keratitis (AK) in patients treated in our department are presented and compared to the literature. PATIENTS AND METHODS: Between 2001 and 2006 a total of 11 patients were treated in our department for Acanthamoeba keratitis. RESULTS: The mean age of the patients was 30 years and the 8 female and 3 male patients were all contact lens wearers. In six cases the right eye was affected and in five cases the left eye. Poor and improper contact lens hygiene was the cause of infection in all cases and 82% of the infections occurred in the summer period between June and September. In addition to long-term conservative treatment, perforating keratoplasty was performed in six cases. After the therapy the best visual acuity was 0.6, but 4 of the patients had a serious visual loss. Follow-up time ranged from 6 months to 5 years. CONCLUSIONS: Early diagnosis and long-term suitable local therapy are necessary for effective recovery. If the patient wears contact lens and there is severe pain with ring infiltration in the cornea, Acanthamoeba infection should be considered and suitable therapy should be given. Immediately performed perforating keratoplasty does not lead to visual improvement. Prevention by informing the patients about adequate hygiene and use of the cleaning solutions is one of the most important tasks of contact lens specialists.
BACKGROUND: With increasing numbers of contact lens wearers, Acanthamoeba infections are also more frequent all over the world and also in Hungary. Despite improved diagnostic and therapeutic possibilities it can still cause serious visual loss. In this study the symptoms, signs, diagnostics and treatment options for Acanthamoeba keratitis (AK) in patients treated in our department are presented and compared to the literature. PATIENTS AND METHODS: Between 2001 and 2006 a total of 11 patients were treated in our department for Acanthamoeba keratitis. RESULTS: The mean age of the patients was 30 years and the 8 female and 3 male patients were all contact lens wearers. In six cases the right eye was affected and in five cases the left eye. Poor and improper contact lens hygiene was the cause of infection in all cases and 82% of the infections occurred in the summer period between June and September. In addition to long-term conservative treatment, perforating keratoplasty was performed in six cases. After the therapy the best visual acuity was 0.6, but 4 of the patients had a serious visual loss. Follow-up time ranged from 6 months to 5 years. CONCLUSIONS: Early diagnosis and long-term suitable local therapy are necessary for effective recovery. If the patient wears contact lens and there is severe pain with ring infiltration in the cornea, Acanthamoeba infection should be considered and suitable therapy should be given. Immediately performed perforating keratoplasty does not lead to visual improvement. Prevention by informing the patients about adequate hygiene and use of the cleaning solutions is one of the most important tasks of contact lens specialists.
Authors: Shady T Awwad; Dipak N Parmar; Michelle Heilman; R Wayne Bowman; James P McCulley; H Dwight Cavanagh Journal: Am J Ophthalmol Date: 2005-12 Impact factor: 5.258