Abstract

PurposeTo analyze the epidemiological and clinical features of Acanathamoeba keratitis AK and to assess the risk factors of this corneal infection in contact lens CL wearers in a tertiary center of Tunisia, North Africa. MethodsWe carried out a retrospective study between January 2008 and December 2019 in the ophthtalmology department of a referral center, Sousse, Tunisia. A review of the chart of 248 patients using CL and diagnosed with presumed infectious keratitis was done.Socio demographic, risk behaviors and microbiological findings in case of AK were analyzed. The mean follow-up was 18 months (1 month–4 years). ResultsAK was diagnosed in 29 cases (11.7% of contact lens wearers with infectious keratitis). These 29 cases were analyzed. The mean age at the time of diagnosis was 33, 44 ± 26, 9 years. Almost of the patients (13; 44.82%) used soft monthly disposable contact lenses. Some risk behaviors related to contact lens wearing were found in our study like not washing and drying hands before CL wear, sleeping in CL, topping off, not respecting the adequate replacement frequency and showering or swimming in CL.After treatment, visual acuity improved only in 10 cases (34.48%), remained the same in 11 cases (37.93%) and worsened in 8 cases (27.58%). ConclusionClinicians must suspect AK in each CL wearer with suggestive clinical signs to allow earlier treatment and better prognosis. Public prevention messages that encourage CL wearers to respect the hygiene rules should be broadly applicable to each person using any type of CL, to minimize the risk of AK.

Highlights

  • Acanthamoeba keratitis (AK) is an uncommon disease but a sightthreatning corneal infection caused by Acanthamoeba

  • All the patients benefited from a corneal scraping, lens and storage cases were analyzed in 224 cases

  • Of the 29 cases (29 patients, 29 eyes) of Acanthamoeba keratitis, the corneal scraping was negative in 15 cases and the diagnosis of acan­ thamoeba keratitis was made thanks to the examination of lenses or their storage case in association with the clinical findings

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Summary

Introduction

Acanthamoeba keratitis (AK) is an uncommon disease but a sightthreatning corneal infection caused by Acanthamoeba. Over the last 20 years, the frequency of the disease has increased dramatically in both the developing and the developed countries [2] and over 3000 cases have been diagnosed in the United State alone [3]. This was noted parallely to the widespread introduction of soft contact lenses (CL). Some behaviors of CL wearers increase the probability of developing corneal infection such as poor hygiene, swimming with lenses, water contami­ nation and use of a particular lens solution [8]

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