{"title":"<i>Acanthamoeba</i> keratitis in a tertiary referral hospital in central China: demographics, risk factors, clinical presentation, treatments and outcomes.","authors":"Jia-Song Wang, Dan Zhao, Tian-Yu Yao, Xiao-Ying Jiang, Hua-Tao Xie, Ming-Chang Zhang","doi":"10.18240/ijo.2025.06.07","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To investigate the demographics, risk factors, clinical presentation, treatments and outcomes of <i>Acanthamoeba</i> keratitis (AK) in a tertiary referral hospital in central China.</p><p><strong>Methods: </strong>In this noncomparative, retrospective study, a total of 21 AK patients were enrolled between April 2020 and March 2023. All patients underwent anterior segment photography, <i>in vivo</i> confocal microscopy (IVCM), best-corrected visual acuity (BCVA) and anterior segment optical coherence tomography (AS-OCT).</p><p><strong>Results: </strong>The most common potential predisposing factors were contact lens wearing (71.4%), mostly were students, and organic trauma (23.8%), mainly by outdoor workers. And 80.9% of patients were initially misdiagnosed with herpes keratitis. The clinical features were radial keratoneuritis 42.8% (<i>n</i>=9), crude salt-like granular dense infiltration 28.6% (<i>n</i>=6), and corneal ring infiltration 28.6% (<i>n</i>=6). Fifteen patients were completely cured by medical therapy, and six patients with corneal ring infiltration feature were performed conjunctival flap covering surgery (CFCS), three of them later underwent secondary deep anterior lamellar keratoplasty (DALK). All patients completed their follow-up at the Union Hospital, with a total of 20 patients (95.2%) had improved visual acuity after treatment, 1 had no change. Corneal scarring and vascularization were the two most common complications of AK in this study, with incidence rates of 85.7% and 28.6%, respectively.</p><p><strong>Conclusion: </strong>In central China, AK occurs predominantly in contact lens wearers, mainly in students with myopia prevention and control. The radial keratoneuritis with crude salt-like granular dense infiltration can generally be effectively managed with medications. In contrast, corneal ring infiltration necessitates immediate surgical intervention. The CFCS combined with secondary DALK is effective for patients with high-risk AK in this condition.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"18 6","pages":"1016-1022"},"PeriodicalIF":1.9000,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120450/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.18240/ijo.2025.06.07","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Aim: To investigate the demographics, risk factors, clinical presentation, treatments and outcomes of Acanthamoeba keratitis (AK) in a tertiary referral hospital in central China.
Methods: In this noncomparative, retrospective study, a total of 21 AK patients were enrolled between April 2020 and March 2023. All patients underwent anterior segment photography, in vivo confocal microscopy (IVCM), best-corrected visual acuity (BCVA) and anterior segment optical coherence tomography (AS-OCT).
Results: The most common potential predisposing factors were contact lens wearing (71.4%), mostly were students, and organic trauma (23.8%), mainly by outdoor workers. And 80.9% of patients were initially misdiagnosed with herpes keratitis. The clinical features were radial keratoneuritis 42.8% (n=9), crude salt-like granular dense infiltration 28.6% (n=6), and corneal ring infiltration 28.6% (n=6). Fifteen patients were completely cured by medical therapy, and six patients with corneal ring infiltration feature were performed conjunctival flap covering surgery (CFCS), three of them later underwent secondary deep anterior lamellar keratoplasty (DALK). All patients completed their follow-up at the Union Hospital, with a total of 20 patients (95.2%) had improved visual acuity after treatment, 1 had no change. Corneal scarring and vascularization were the two most common complications of AK in this study, with incidence rates of 85.7% and 28.6%, respectively.
Conclusion: In central China, AK occurs predominantly in contact lens wearers, mainly in students with myopia prevention and control. The radial keratoneuritis with crude salt-like granular dense infiltration can generally be effectively managed with medications. In contrast, corneal ring infiltration necessitates immediate surgical intervention. The CFCS combined with secondary DALK is effective for patients with high-risk AK in this condition.
期刊介绍：
· International Journal of Ophthalmology-IJO (English edition) is a global ophthalmological scientific publication
and a peer-reviewed open access periodical (ISSN 2222-3959 print, ISSN 2227-4898 online).
This journal is sponsored by Chinese Medical Association Xi’an Branch and obtains guidance and support from
WHO and ICO (International Council of Ophthalmology). It has been indexed in SCIE, PubMed,
PubMed-Central, Chemical Abstracts, Scopus, EMBASE , and DOAJ. IJO JCR IF in 2017 is 1.166.
IJO was established in 2008, with editorial office in Xi’an, China. It is a monthly publication. General Scientific
Advisors include Prof. Hugh Taylor (President of ICO); Prof.Bruce Spivey (Immediate Past President of ICO);
Prof.Mark Tso (Ex-Vice President of ICO) and Prof.Daiming Fan (Academician and Vice President,
Chinese Academy of Engineering.
International Scientific Advisors include Prof. Serge Resnikoff (WHO Senior Speciatist for Prevention of
blindness), Prof. Chi-Chao Chan (National Eye Institute, USA) and Prof. Richard L Abbott (Ex-President of
AAO/PAAO) et al.
Honorary Editors-in-Chief: Prof. Li-Xin Xie(Academician of Chinese Academy of
Engineering/Honorary President of Chinese Ophthalmological Society); Prof. Dennis Lam (President of APAO) and
Prof. Xiao-Xin Li (Ex-President of Chinese Ophthalmological Society).
Chief Editor: Prof. Xiu-Wen Hu (President of IJO Press).
Editors-in-Chief: Prof. Yan-Nian Hui (Ex-Director, Eye Institute of Chinese PLA) and
Prof. George Chiou (Founding chief editor of Journal of Ocular Pharmacology & Therapeutics).
Associate Editors-in-Chief include:
Prof. Ning-Li Wang (President Elect of APAO);
Prof. Ke Yao (President of Chinese Ophthalmological Society) ;
Prof.William Smiddy (Bascom Palmer Eye instituteUSA) ;
Prof.Joel Schuman (President of Association of University Professors of Ophthalmology,USA);
Prof.Yizhi Liu (Vice President of Chinese Ophtlalmology Society);
Prof.Yu-Sheng Wang (Director of Eye Institute of Chinese PLA);
Prof.Ling-Yun Cheng (Director of Ocular Pharmacology, Shiley Eye Center, USA).
IJO accepts contributions in English from all over the world. It includes mainly original articles and review articles,
both basic and clinical papers.
Instruction is Welcome Contribution is Welcome Citation is Welcome
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International Council of Ophthalmology(ICO), PubMed, PMC, American Academy of Ophthalmology, Asia-Pacific, Thomson Reuters, The Charlesworth Group, Crossref,Scopus,Publons, DOAJ etc.
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