June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Risk factors and Contact Lens Modality in Patients with Acanthamoeba Keratitis
Author Affiliations & Notes
  • Angelica C. Scanzera
    Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Hannah H Yoon
    Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Ellen Shorter
    Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Elmer Tu
    Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Angelica Scanzera None; Hannah Yoon None; Ellen Shorter Johnson & Johnson, BostonSight, Contamac, Art Optical, SynergEyes, Code F (Financial Support); Elmer Tu Dompe, Eversight, Oyster Point Pharma, GSK, Daiichi Sankyo, Code F (Financial Support)
  • Footnotes
    Support  National Institutes of Health grants: NEI P30 EY001792, UL1TR002003, K12 EY02175 (Scanzera) and an unrestricted grant from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 539 – A0237. doi:
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    • Get Citation

      Angelica C. Scanzera, Hannah H Yoon, Ellen Shorter, Elmer Tu; Risk factors and Contact Lens Modality in Patients with Acanthamoeba Keratitis. Invest. Ophthalmol. Vis. Sci. 2022;63(7):539 – A0237.

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

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Abstract

Purpose : Acanthamoeba keratitis (AK) is a rare but potentially visually devastating ocular infection. Diagnosis can be challenging, often resulting in misdiagnosis with delayed treatment. Individuals with history of contact lens use and improper lens handling including exposure to water or corneal trauma are at higher risk of infection.
The purpose of this study was to describe patient demographics, time from symptom onset to diagnosis, time from presentation to clinic to diagnosis and risk factors in patients diagnosed with AK at a tertiary care center.

Methods : Medical records of all patients evaluated at the Illinois Eye and Ear Infirmary (IEEI) between 2015 and 2020 with a diagnosis of AK were reviewed. Patients with a new diagnosis of AK during the study period were included. This study was approved by the University of Illinois at Chicago Institutional Review Board.

Results : There were 58 patients identified with AK including 5 patients (8.6%) with bilateral disease. Mean age was 38.7 years (range 12 to 80) with 55.2% females. The majority (94.8%) were contact lens wearers using soft lenses (65.5%) followed by corneal gas permeable (21.8%), hybrid (5.5%), and scleral lenses (1.8%). There was documented exposure to water including rinsing lenses in water, swimming in pools, lakes, hot tub use and showering in almost half of the patients (48.3%). Overnight lens use was documented in 29.3% including three orthokeratology lens users.
Mean time from symptom onset was 44 days ± 51, and mean time from presentation at IEEI to diagnosis was 3 days ± 8. Confocal microscopy was performed on 48 patients and cysts consistent with acanthamoeba were present in 41 of those patients (93.2%) while cultures were positive in only 17 of 38 patients (44.7%).

Conclusions : In this case series, 35.5% of contact lens related AK cases were in rigid and hybrid lens users. Previous epidemiologic studies found that 85-88% of contact lens related AK infections are in soft lens users, and among U.S. contact lens prescribers, soft lenses consist of 95% of lens fits. This data suggests that the risk of AK in rigid and hybrid lens users may be increasing. A future well-designed case-control study may assist in evaluating the relationship between AK and different lens modalities.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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