A study of the spectrum of Acanthamoeba keratitis: a three-year study at a tertiary eye care referral center in South India.
Indian J Ophthalmol
;
2007 Jan-Feb; 55(1): 37-42
Article
in English
| IMSEAR
| ID: sea-71415
ABSTRACT
PURPOSE:
To determine the epidemiological and clinical characteristics of Acanthamoeba keratitis and also to determine the sensitivity and specificity of smears in the detection of Acanthamoeba. MATERIALS ANDMETHODS:
A retrospective review of all culture-positive cases of Acanthamoeba keratitis seen between October 1999 and August 2002 was performed. Corneal scrapes were subjected to culture and microscopy using standard protocols.RESULTS:
Out of 3183 consecutive patients with clinically diagnosed corneal ulcers evaluated, 33 (1.04%) were found to be due to Acanthamoeba. Twenty-four out of 33 (72.72%) were less than 51 years of age (P<0.001). All patients were from rural areas (P<0.001) and 26 (78.79%) of them were agricultural workers (P=0.031). All 33 had history of corneal injury (P<0.001) and 28 (84.85%) patients had injury with mud (P<0.001). All 33 (100%) patients had previous medical treatment (P=0.009) and 10 (30.3%) had used traditional eye medicines (P=0.183). A clinical pattern of ring infiltrate was characteristic in 15 (45.45%) patients. The diameter of the corneal ulcer was more than 6 mm in 27 (81.82%) eyes (P<0.001). Twenty-six (78.79%) patients had visual acuity of perception of light on initial presentation (P<0.001) and 24 (72.73%) had the same as their final visual outcome. The sensitivity of 10% potassium hydroxide (KOH) preparation was found to be higher (P<0.001) in the detection of Acanthamoeba cysts.CONCLUSION:
The incidence of Acanthamoeba keratitis amongst the corneal ulcer patients was 1% in this setting and it was mainly due to corneal injury by mud. The KOH preparation is a sensitive diagnostic tool for the detection of Acanthamoeba. Delayed diagnosis or misdiagnosis and inappropriate antimicrobial therapy results in poor visual outcome.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Soil
/
Female
/
Humans
/
Male
/
Acanthamoeba Keratitis
/
Corneal Ulcer
/
Eye Injuries
/
Incidence
/
Retrospective Studies
/
Sensitivity and Specificity
Type of study:
Diagnostic study
/
Practice guideline
/
Incidence study
/
Observational study
/
Prognostic study
Country/Region as subject:
Asia
Language:
English
Journal:
Indian J Ophthalmol
Year:
2007
Type:
Article
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