Risk factors and clinical signs of severe Acanthamoeba keratitis

Figures & data

Table 1 Patients’ profile of severe Acanthamoeba keratitis cases group and mild Acanthamoeba keratitis cases group

Case	Age	Gender	Contact lens type	Systemic disease	Onset–presentation (days)	Onset–diagnosis (days)
S-1	36	Male	2W DSCL	Diabetes mellitus	12	26
S-2	51	Male	1M DSCL	Hypertension	15	17
S-3	25	Female	1M DSCL	–	14	14
S-4	35	Male	DSCL (extended wear)	–	150	240
M-1	28	Female	2W DSCL	–	18	18
M-2	15	Female	DSCL	–	5	5
M-3	19	Female	2W color DSCL	–	19	30
M-4	35	Male	Conventional SCL	–	12	12
M-5	17	Female	DSCL	–	9	9
M-6	27	Male	2W DSCL	–	14	14
P-value	0.04	0.52	0.19	0.13	0.19	0.18

Abbreviations: DSCL, disposable soft contact lens; M, month; M-, mild group-; S-, severe group-; W, week.

Table 2 Patients’ data at first visit and diagnostic method of severe and mild Acanthamoeba cases

Case	BCVA	Slit examination	Disease stage	Conjunctiva culture	Method of diagnosis
S-1	0.7	Keratoneuritis	2	–	Clinical
S-2	0.01	Ring ulcer	5	Staphylococcus epidermis	Cyst
S-3	0.6	Disciform ulcer	4	–	Cyst
S-4	0.8	Superficial punctate keratopathya	1a	–	Clinical
M-1	0.9	Pseudo dendritica	3	–	Cyst
M-2	0.6	Keratoneuritis	2	–	Clinical
M-3	0.6	Superficial punctate keratopathy	1	–	Cyst
M-4	1.2	Keratoneuritis	2	–	Cyst
M-5	0.15	Keratoneuritis	2	–	Cyst
M-6	0.9	Keratoneuritis	2	–	Clinical
P-value	0.23	0.62	0.62	0.4	1

Note:

a S-4 had ring ulcer so he was stage 4 when diagnosis.

Abbreviations: BCVA, best corrected visual acuity; M-, mild group-; S-, severe group-.

Table 3 Steroid eye drop use before diagnosis, the existence of keratoprecipitates during follow-up, cornea scraping times, visual acuity at last visit, and follow-up period

Case	Steroid drops use	Steroid drops types	Scraping times	Keratoprecipitates	Last visual acuity
S-1	+	Betamethasone	11	+	0.8a
S-2	+	Fluorometholone	26	+	Hand movement
S-3	+	Betamethasone	11	+	0.2
S-4	+	Betamethasone	7	+	0.07
M-1	−		13	−	1.2
M-2	+	Fluorometholone	2	−	1.2
M-3	+	Fluorometholone	5	−	1.2
M-4	+	Fluorometholone	5	−	1.2
M-5	−		3	−	1.2
M-6	+	Fluorometholone	5	+	1.2
P-value	0.2	0.07	0.07	0.01	0.12

Note:

a After therapeutic keratoplasty.

Abbreviations: M-, mild group-; S-, severe group-.

Figure 1 Slit-lamp photographs.

Notes: (A–D) Case S-2. (A) Filthy soft contact lens case, (B) ring ulcer at first visit, (C) disciform infiltrations with keratoprecipitates at 2 months after referral, and (D) corneal scar and mature cataract at 12 months after referral. (E–G) Case S-4. (E) Superficial punctate keratopathy at first visit, (F) ring infiltration with keratoprecipitates at 3 months after referral, and (G) corneal scar at 2 years after referral. (H and I) Case M-5. (H) Keratoneuritis and ciliary injection at first visit, and (I) clear cornea at 3 weeks after referral.