Abstract
Purpose :
Acanthamoeba keratitis (AK) is a well-known sight-threatening condition associated with contact lenses. Early diagnosis and therapy response assessment remain clinical challenges. Recent studies suggest that anterior segment optical coherence tomography (AS-OCT) can detect radial keratoneuritis (RK) in AK. Despite this, it is unclear if the presence of RK or quantitative RK parameters are clinically useful. Using AS-OCT, we detected changes in the RK in patients with AK throughout their clinical course, from presenting symptoms to treatment resolution.
Methods :
A retrospective, observational clinical study was conducted to assess changes in the RK during the AK clinical course using AS-OCT. In 26 patients with confirmed AK on confocal microscopy or culture, serial AS-OCT imaging was performed at presentation and multiple time points until infection resolution.
The AS-OCT images were examined for RK. Measurements were taken at each visit to determine the length, width, and depth of the RK. Using a standardised imaging protocol, each parameter was measured over time. The data collected was analysed to show the mean change of RK features.
Results :
In our cohort, 61.5% of patients had multiple inflamed nerves in the form of RK at presentation. There were 11 patients with complete clinical data series showing RK which were subsequently analysed. Mean RK length showed a significant decrease from 516 μm on day 0 (time of presentation) to 309 μm on day 111 (p=0.030). Mean RK width decreased from 64 μm (day 0) to 34 μm (day 111; p=0.016), and the mean RK depth reduced from 421 μm (day 0) to 275 μm (day 111; p=0.002). The resolution of RK coincided with the improvement of symptoms and possible recovery.
Conclusions :
The results of this study provide additional evidence supporting the use of AS-OCT in detecting RK in patients suffering from AK. The measurement of RK over time of AK offers an objective method for monitoring clinical response to treatment.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.