Ocular Microbiology and Immunology Group
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2017 OMIG Abstract 25

Acanthamoeba Keratitis: Are Recent Infections More Severe?
Mehdi Roozbahani MD, Kristin M. Hammersmith, MD, Sophia Y. Siu, MD, Christopher J. Rapuano, MD,
and Parveen K. Nagra, MD
Cornea Service, Wills Eye Institute, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania

Purpose: Acanthamoeba keratitis (AK) infection is a devastating condition that often results in poor outcomes. There is concern that recent AK infections have had worse outcomes than reported in previous literature. The purpose of our study is to report the recent outcomes of a large series of AK infections and identify risk factors for failure of treatment.

Methods: A retrospective review identified 68 patients that were diagnosed with AK and treated at our institution from January 1, 2009 to December 31, 2015. Sixty patients had complete follow-up data and were included in our study. Patient demographics, clinical details, treatment protocols, and outcomes were collected. Treatment failure was defined as requiring penetrating keratoplasty (PKP) and/or having best-corrected visual acuity (BCVA) worse than 20/100 at the last follow-up. Univariate analysis and multivariate logistic regression were performed to identify independent predictors of treatment failure. 

Results: From 2009 to 2011, 7 of 26 eyes (27%) failed treatment. In comparison, from 2012 to 2015, 18 of 34 eyes (53%) failed treatment (p=0.043). Univariate analysis demonstrated that failure was associated with older age, longer duration of symptoms prior to presentation, poorer presenting BCVA, and positive diagnosis on pathology. Multivariate analysis identified worse initial BCVA and longer duration of symptoms prior to presentation as independent risk factors for treatment failure of AK. Increasing age trended towards significance in our multivariate model.

Conclusions: Our study shows a high rate of AK treatment failure at a large academic institution.  AK cases from 2012-15 had worse outcomes compared with cases from 2009-11(p=0.043), which was approaching significance. A study conducted at our institution from 2004-08 found that 35% of eyes failed treatment (p=0.33). Older patients with longer duration of symptoms prior to presentation and worse initial BCVA need to be counseled about possible poor outcomes.

Disclosure: N

2017 Agenda and Abstracts | < Previous Next >