Non-contact lens related Acanthamoeba keratitis at a tertiary eye care center in south India: Implications for eye care programs in the region.
Muthaiah Srinivasan, Sanghamitra Burman, Celine George, Praveen K. Nirmalan
Med Sci Monit 2003; 9(4): CR125-129
BACKGROUND: The purpose of our research was to determine diagnosis and outcomes for non-contact lens related Acanthamoeba keratitis in south India. MATERIAL/METHODS: A retrospective review of the medical and microbiology records of culture-positive Acanthamoeba cases presenting between 1987 and 2001 to a tertiary eye care center in south India. RESULTS: One hundred and three culture-positive cases of Acanthamoeba were identified during chart review. The majority of these cases (70.9%) were already on treatment for keratitis with antibiotics, antifungal and antiviral regimes prior to our examination; 45.2% were on different combinations of regimes. Cysts could be identified using 10% KOH mount in 83.5% of these cases. Clinical resolution with medical therapy was achieved for 83.5% of the cases; the median duration of treatment was 90.5 days. Outcomes - either clinical or visual - did not differ between CONCLUSIONS: Acanthamoeba keratitis cases presenting to this tertiary care center were non-contact lens wearers, and already on empirical treatment for either bacterial or fungal keratitis. A basic lab facility including only microscopy and smear examinations may aid etiological diagnosis of corneal ulcers, and reduce the current practice of using combinations of treatment regimes on an empirical basis.
Keywords: Acanthamoeba - isolation & purification, Acanthamoeba Keratitis - diagnosis, Acanthamoeba Keratitis - drug therapy, Acanthamoeba Keratitis - epidemiology, Acanthamoeba Keratitis - etiology, Antibiotics, Antifungal - therapeutic use