Abstract
Purpose :
To unveil the long-term prognosis of Acanthamoeba keratitis based on clinical presentation and timing of diagnosis to better inform patients since first visit regarding their length of treatment, quality of life, and visual function.
Methods :
Retrospective observational study enrolling patients with Acanthamoeba keratitis from 1994 to 2019. Patients with complete eye examination and medical records were analyzed. Severity of the disease, the time from onset of symptoms to the appropriate therapeutic regimen, the time until clinical resolution, visual function, long-term follow-up, and quality of life were evaluated.
Results :
Thirty-five patients (40 eyes) were assessed. The overall healing time of patients with Acanthamoeba keratitis was 12.5±3.5 months, while patients with a severe corneal ulcer (stage III) had a significant longer healing time (16.2±3.7 months) compared to patients with stage II (7.04±0.7 months) or I (7.7±1.5 months; p<0.05). Patients who received a prompt therapy (<30 days form symptoms onset) had a reduced healing time compared to patients with a delayed diagnosis (p<0.01). Quality of life was reduced in all patients (86.6±17); patients that were diagnosed early (< 30 days from onset) showed a lower reduction in quality of life than in patients that were diagnosed >30 days from onset.
Conclusions :
Delayed diagnosis of Acanthamoeba keratitis and disease severity significantly increase healing time and duration of treatment. The time to diagnosis and disease stage at diagnosis predict the duration of treatment, the final outcome, quality of life, and the requirement of surgery. These data would allow to promptly inform patients about long term disease timeline, future outcomes, improving disease acceptance and quality of life.
This is a 2020 ARVO Annual Meeting abstract.