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Thomas Armin Fuchsluger, Mathias Roth, Anna Scheumann, Andre Philipp Klamann, Gerd Geerling; Acanthamoeba keratitis: Retrospective analysis of cases of the last 20 years at Dusseldorf University Hospital. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5136.
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Acanthamoeba infections of the cornea are characterized by a dramatic course with increasing pain and significant reduction of visual acuity. Increasing numbers of acanthamoeba keratitis cases are reported from developed countries, along with increased use of soft contact lenses. Aim of this study is to retrospectively analyze all cases at Dusseldorf University Hospital since 1993. Currently, these patients undergo follow-up examinations.
Identification of acanthamoeba keratitis cases of the last 20 years by systematic analysis of the clinics photo departments‘ database and analysis of parameters related to diagnosis, therapy and course of the disease. Single examinations without further follow-up or therapeutic guidance through the University Hospital were excluded.
54 cases (mean age 48 years [range 27-74], 18 male, 36 female) were analyzed. Mean time from onset of first symptoms to consultation in our department was 3 months. Diagnosis was mainly clinically and secured by additional microbiological (10,7%) or histological (30,3%) examinations. 81.5 of patients were contact lens wearers. 57.4% were sent to University Hospital with a false initial diagnosis (mainly herpes keratitis, 35.2%). An initial therapy with brolene and / or lavasept was administered in 89.3%. 34 cases had to undergo penetrating keratoplasty, amongst them 73.9% secured diagnosis.
In the last 20 years, acanthamoeba keratitis was primarily diagnosed clinically. Successful therapy approved the initial diagnosis. Visual rehabilitation could be achieved by penetrating keratoplasty. Interestingly, with 2.5 cases per year, an increase in cases could not be documented over the last 20 years in our collective.
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