June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Acanthamoeba Keratitis: Perspectives for Patients
Author Affiliations & Notes
  • Antonio Di zazzo
    Campus Bio Medico Univeristy, Italy
  • giuseppe varacalli
    Campus Bio Medico Univeristy, Italy
  • marco coassin
    Campus Bio Medico Univeristy, Italy
  • Stefano Bonini
    Campus Bio Medico Univeristy, Italy
  • Footnotes
    Commercial Relationships   Antonio Di zazzo, None; giuseppe varacalli, None; marco coassin, None; Stefano Bonini, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4892. doi:
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      Antonio Di zazzo, giuseppe varacalli, marco coassin, Stefano Bonini; Acanthamoeba Keratitis: Perspectives for Patients. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4892.

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      © ARVO (1962-2015); The Authors (2016-present)

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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.

 

The time of diagnosis and disease severity of acanthamoeba keratitis determine the healing time. (A) Corneal healing time (months) from diagnosis to resolution of the disease is shown according to (A) disease stage and (B) time of diagnosis (< vs. > 30 days from symptoms onset). ANOVA, *p<0.05; ** p<0.01; *** p<0.001.

The time of diagnosis and disease severity of acanthamoeba keratitis determine the healing time. (A) Corneal healing time (months) from diagnosis to resolution of the disease is shown according to (A) disease stage and (B) time of diagnosis (< vs. > 30 days from symptoms onset). ANOVA, *p<0.05; ** p<0.01; *** p<0.001.

 

The disease severity determines the final visual outcome and the need of surgery. (A) Functional visual outcome of patients according to their disease stage is shown. (B) Rate of patients that received surgery (transplantation) according to their disease stage. ANOVA *p<0.05; ** p<0.01; *** p<0.001

The disease severity determines the final visual outcome and the need of surgery. (A) Functional visual outcome of patients according to their disease stage is shown. (B) Rate of patients that received surgery (transplantation) according to their disease stage. ANOVA *p<0.05; ** p<0.01; *** p<0.001

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