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2012 Agenda and Abstracts | < Previous | Next >

2012 OMIG Abstract 22

Microbiology Work-up in the Diagnosis of Non-Contact Lens Related Acanthamoeba Keratitis
P. Garg1, R. Jain1, S. Reddy2, K. Mulay3

1Cornea and Anterior Segment Services; 2Jhaveri Microbiology Laboratory; 3Ophthalmic Pathology Laboratory, L V Prasad Eye Institute; Banjara Hills Hyderabad, India

Purpose: To evaluate microbiology work-up & define the role of confocal microscopy in primary diagnosis of acanthamoeba keratitis

Methods: Clinical, microbiology and histopathology records of all patients who were diagnosed and managed as acanthamoeba keratitis from 2007 to 2011 were reviewed. Patients with a history of contact lens wear and those with neither microbiological nor histopathology confirmation were excluded. Detailed microbiology work-up was done in all patients of ulcerative keratitis. All biopsy specimen and half corneal buttons were subjected to histopathology examination.

Results: A total of one hundred and ninety-four patients were diagnosed to have acanthamoeba keratitis during the study period. Smear examination was positive for acanthamoeba in 82.5% cases on first scraping & in 97.4% cases overall on repeat scrapings. Culture was positive in 79.4% cases. 10% potassium hydroxide with calcoflur white yielded better results (87.1 v/s 71.1%) than Gram’s stain. Five patients (2.57%) were diagnosed on histopathology and were missed on microbiology.

Conclusions: Diagnosis of non-contact lens related acanthamoeba keratitis can reliably be made by microscopic examination of corneal scrapings. Diagnostic confocal microscopy has a limited role.

Disclosure: Presenting author is consultant to Alcon India, Bausch and Lomb and Novabay. Remaining authors do not have any financial interest.

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