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Recent Acanthamoeba keratitis infections more severe

Issue: April 25, 2017

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PHILADELPHIA — According to a retrospective review conducted at Wills Eye Hospital, Acanthamoeba keratitis infections have become statistically more severe, a speaker said at the Wills Eye Conference.

“Acanthamoeba keratitis is a serious infection with a high rate of treatment failure,” Sophia Siu, MD, said.

Sophia Siu

The study analyzed patients diagnosed with the condition between 2009 and 2015 to determine if recent cases were more severe or had a greater rate of treatment failure, which was described as those who required penetrating keratoplasty or had a best corrected visual acuity worse than 20/100 after treatment.

The researchers looked at 60 eyes of 57 patients and found that between 2009 and 2011 there was a 27% failure rate, whereas from 2012 to 2015 there was a 53% failure rate. In the earlier group, 5.8% of patients required penetrating keratoplasty compared with 26.5% in the later group.

“There was a statistically significantly higher patient failure rate,” Siu said of the more recent cases.

In addition, a multivariable analysis was performed to look at the risk factors associated with treatment failure. The review showed there was no difference between the time to treatment, presenting vision or age; however, the most recent group did include a higher rate of steroid use before diagnosis.

The researchers also compared their data with a 2004 to 2008 study done at Wills Eye that used similar criteria and had a 35% failure rate.

“Older patients and those with later diagnosis or worse initial vision need to be counseled about the increased risk of poor outcomes following treatment for Acanthamoeba keratitis,” Siu said. “And more research is needed to assess why those infections have worse outcomes recently.” — by Rebecca L. Forand

Reference:

Siu S. Acanthamoeba keratitis: Are recent infections more severe? Presented at: Wills Eye Conference; March 9-11, 2017; Philadelphia.

Disclosure: Siu reports no relevant financial disclosures.