Ocular Microbiology and Immunology Group
Back to OMIG Main Page

< Previous | 2025 Agenda and Abstracts >

POSTER PRESENTATION

Retrospective Review of Late-Onset Interstitial Keratitis in Post-Treatment Acanthamoeba Keratitis

Grace Tu¹, Elmer Y. Tu<sup>2

1</sup>University of Illinois College of Medicine, Peoria, Illinois; ²University of Illinois Chicago Department of Ophthalmology and Visual Sciences, Chicago, Illinois

Purpose: To describe the incidence and management of a novel late-onset interstitial keratitis in post-treatment Acanthamoeba keratitis (AK).

Methods: Retrospective review of all cases of AK diagnosed and treated at the University of Illinois Eye and Ear Infirmary from January 1995 to August 2019. Cases exhibiting signs of interstitial keratitis greater than 1 month after completion of anti-Acanthamoebal therapy are identified. Patient demographics, prior anti-Acanthamoebal treatment, and length of treatment prior to completion of therapy were noted. Clinical characteristics including pattern and location of post-infectious stromal inflammation, clinical management and clinical course were analyzed to provide guidelines for recognition and treatment.

Results: A total of 265 cases were reviewed. Eight patients with late-onset interstitial keratitis (IK) post-treatment were identified; 2, previously published, were treated successfully with oral Voriconazole. The mean age at presentation was 23.4 years. The mean age for remaining 257 cases was 35.1 years, exhibiting a statistically significant difference between the two groups (p=0.004). The mean length of AK treatment and time from completion to recurrence was 253.7 days (range: 83-462 days) and 165.8 days (range: 63-258 days), respectively. All patients received post-treatment steroids, and 2 patients also received anti-AK treatment.

Conclusions: The data suggests an association between delayed onset interstitial keratitis following AK treatment and younger age at AK diagnosis. Furthermore, these episodes may be inflammatory and not infectious. These findings warrant further investigation but may help direct therapy of post-AK treatment IK.