Abstract
Purpose: :
To update the continued increase of Acanthamoeba keratitis (AK) at the New York Eye and Ear Infirmary (NYEEI) in 2008.
Methods: :
Retrospective consecutive case series of all eyes diagnosed with AK from January 2005-November 2008.
Results: :
43 eyes of 43 patients have been diagnosed with AK since 2005. Two patients were diagnosed in 2005, 8 patients in 2006, 18 patients in 2007 and 17 patients so far this year in 2008. Eight cases have been reported in the last two months. Of the 18 new cases in 2008, 17 were in contact lens wearers and one was related to trauma. 14 of the 17 new cases had positive AK cultures and 12 of 17 had positive confocal microscopy results. 2 of 17 eyes had negative cultures but were diagnosed by confocal microscopy. One patient was diagnosed by clinical appearance, symptoms, and response to therapy. Six patients were using ReNu Multiplus®, 5 patients were using Alcon OPTI-FREE® RepleniSH®, 4 patients were using AMO Complete®MPS EasyRubTM,one was still using AMO Complete®MoistureplusTM (recalled May 2007) and one was using a saline made for Sam's Club (Members Mark®). A CDC report of 14 ophthalmology centers of which NYEEI is a member (CDC contact Jonathan Yoder) in June of this year, reports a decreased incidence of AK in 2008 as compared to 2007.
Conclusions: :
Our Acanthamoeba outbreak that began in October of 2006 nearly 12-18 months after those reported in Philadelphia and Chicago continues into 2008 despite the CDC report. This may partly be a consequence of our microbiology laboratory reputation within the NY metropolitan area.
Keywords: Acanthamoeba • microscopy: confocal/tunneling • amoeba