Joyce Chin1, Alvin L Young1, Mamie Hui2, Vishal Jhanji3. 1. Department of Ophthalmology, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China. 2. Department of Microbiology, The Chinese University of Hong Kong, Hong Kong, China. 3. Department of Ophthalmology, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: vishaljhanji@gmail.com.
Abstract
PURPOSE: To review clinical presentation, investigation results and treatment outcomes of patients with Acanthamoeba keratitis (AK) at a tertiary eye care center in Hong Kong. METHODS: A retrospective case review was performed for cases of Acanthamoeba keratitis diagnosed at the Prince of Wales Hospital, Hong Kong over a 10-year period. RESULTS: Fifteen eyes of 13 patients were treated for AK over the study period. 12 out of 13 patients (92.3%) were contact lens wearers. All patients presented with blurred vision and pain, while 9 patients (69.2%) presented with redness of the affected eye. The most common ocular sign was diffuse corneal haze or ground glass appearance of the cornea (69.2%) followed by anterior chamber inflammation (53.8%), ring infiltrate (38.4%), epithelial defect (38.4%), perineural infiltrates (30.7%) and satellite lesions (15.3%). Acanthamoeba was detected on corneal scrapings in 4 eyes and on confocal microscopy in 4 eyes. The mean duration of treatment was 140 ± 50.8 days. Surgical intervention was required in two cases due to uncontrolled eye infection and progressive corneal thinning. All patients had improvement in visual acuity after treatment. CONCLUSIONS: Patients with AK exhibited a wide spectrum of clinical characteristics. Improper care and usage of contact lenses is a major risk factor for Acanthamoeba keratitis. Diagnosis of AK remained a challenge. Timely diagnosis and appropriate treatment with amoebicidal drugs can improve the outcomes of Acanthamoeba keratitis.
PURPOSE: To review clinical presentation, investigation results and treatment outcomes of patients with Acanthamoeba keratitis (AK) at a tertiary eye care center in Hong Kong. METHODS: A retrospective case review was performed for cases of Acanthamoeba keratitis diagnosed at the Prince of Wales Hospital, Hong Kong over a 10-year period. RESULTS: Fifteen eyes of 13 patients were treated for AK over the study period. 12 out of 13 patients (92.3%) were contact lens wearers. All patients presented with blurred vision and pain, while 9 patients (69.2%) presented with redness of the affected eye. The most common ocular sign was diffuse corneal haze or ground glass appearance of the cornea (69.2%) followed by anterior chamber inflammation (53.8%), ring infiltrate (38.4%), epithelial defect (38.4%), perineural infiltrates (30.7%) and satellite lesions (15.3%). Acanthamoeba was detected on corneal scrapings in 4 eyes and on confocal microscopy in 4 eyes. The mean duration of treatment was 140 ± 50.8 days. Surgical intervention was required in two cases due to uncontrolled eye infection and progressive corneal thinning. All patients had improvement in visual acuity after treatment. CONCLUSIONS:Patients with AK exhibited a wide spectrum of clinical characteristics. Improper care and usage of contact lenses is a major risk factor for Acanthamoeba keratitis. Diagnosis of AK remained a challenge. Timely diagnosis and appropriate treatment with amoebicidal drugs can improve the outcomes of Acanthamoeba keratitis.