Clinico-Microbiological Review of Non-Contact-Lens-Associated Acanthamoeba Keratitis

Abstract

Clinical/microbiological records of 194 patients with microbiological/histopathological diagnosis of Acanthamoeba keratitis from 2007-11 without history of contact lens wear were retrospectively studied. Positive results on corneal scraping and culture were analyzed. Patients were divided based on positive first smear report (group 1/2) and time of presentation (group 3/4). Primary and secondary outcome measures were microbiological positivity rate and to find any possible differences at presentation in sub-groups, respectively. Mean age of patients was 38.5 ± 13.7 years, M:F was 1.8:1. Positivity of first smear examination was 82% and was 98% overall in three scrapings. Ten percent potassium hydroxide with calcoflur white was better than Grams stain (87.1 versus 71.1%). Culture was positive in 79.4% cases. Sub-group analysis showed clinically/demographically similar groups 1 and 2 (p > 0.05). Patients who presented within a month of symptoms (group 3) were significantly younger than others (p = 0.012). Microscopic diagnosis of non-contact-lens Acanthamoeba keratitis is reliable.

• Acanthamoeba keratitis
• microbial keratitis
• microscopy
• non-contact-lens
• time of presentation

Acknowledgements

Funding/Support: This work was funded by the Hyderabad Eye Research Foundation, Hyderabad, India. The funding agency, however, did not have any role in the design, collection, analysis and interpretation of the data.

Financial Disclosure: Prashant Garg is a consultant to Alcon, Bausch and Lomb and Novabay. None of these agencies were, however, related to this study in any form. The other authors had no financial disclosures.

RJ and MBG performed the literature review. RJ analyzed the data and wrote the manuscript. RJ, SR, and PG were responsible for the article’s conception and design. RJ, PG, and SR revised the article critically for important intellectual content. All authors included on the paper fulfill the criteria of authorship. On behalf of all co-authors, Rajat Jain, MS, states that he had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.