Acanthamoeba keratitis in a tertiary referral hospital in central China: demographics, risk factors, clinical presentation, treatments and outcomes

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 Mar...

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Main Authors: Jia-Song Wang, Dan Zhao, Tian-Yu Yao, Xiao-Ying Jiang, Hua-Tao Xie, Ming-Chang Zhang
Format: Article
Language:English
Published: Press of International Journal of Ophthalmology (IJO PRESS) 2025-06-01
Series:International Journal of Ophthalmology
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Online Access:http://ies.ijo.cn/en_publish/2025/6/20250607.pdf
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author Jia-Song Wang
Dan Zhao
Tian-Yu Yao
Xiao-Ying Jiang
Hua-Tao Xie
Ming-Chang Zhang
author_facet Jia-Song Wang
Dan Zhao
Tian-Yu Yao
Xiao-Ying Jiang
Hua-Tao Xie
Ming-Chang Zhang
author_sort Jia-Song Wang
collection DOAJ
description 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.
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2227-4898
language English
publishDate 2025-06-01
publisher Press of International Journal of Ophthalmology (IJO PRESS)
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spelling doaj-art-e5dfd91f1d4947edaf04cdcd2a481f872025-08-20T01:55:34ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982025-06-011861016102210.18240/ijo.2025.06.0720250607Acanthamoeba keratitis in a tertiary referral hospital in central China: demographics, risk factors, clinical presentation, treatments and outcomesJia-Song Wang0Dan Zhao1Tian-Yu Yao2Xiao-Ying Jiang3Hua-Tao Xie4Ming-Chang Zhang5Hua-Tao Xie and Ming-Chang Zhang. Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China. huataoxie@hust.edu.cn; mingc_zhang@hust.edu.cnDepartment of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, ChinaDepartment of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, ChinaDepartment of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, ChinaDepartment of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, ChinaDepartment of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, ChinaAIM: 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.http://ies.ijo.cn/en_publish/2025/6/20250607.pdfacanthamoeba keratitisin vivo confocal microscopycontact lenses
spellingShingle Jia-Song Wang
Dan Zhao
Tian-Yu Yao
Xiao-Ying Jiang
Hua-Tao Xie
Ming-Chang Zhang
Acanthamoeba keratitis in a tertiary referral hospital in central China: demographics, risk factors, clinical presentation, treatments and outcomes
International Journal of Ophthalmology
acanthamoeba keratitis
in vivo confocal microscopy
contact lenses
title Acanthamoeba keratitis in a tertiary referral hospital in central China: demographics, risk factors, clinical presentation, treatments and outcomes
title_full Acanthamoeba keratitis in a tertiary referral hospital in central China: demographics, risk factors, clinical presentation, treatments and outcomes
title_fullStr Acanthamoeba keratitis in a tertiary referral hospital in central China: demographics, risk factors, clinical presentation, treatments and outcomes
title_full_unstemmed Acanthamoeba keratitis in a tertiary referral hospital in central China: demographics, risk factors, clinical presentation, treatments and outcomes
title_short Acanthamoeba keratitis in a tertiary referral hospital in central China: demographics, risk factors, clinical presentation, treatments and outcomes
title_sort acanthamoeba keratitis in a tertiary referral hospital in central china demographics risk factors clinical presentation treatments and outcomes
topic acanthamoeba keratitis
in vivo confocal microscopy
contact lenses
url http://ies.ijo.cn/en_publish/2025/6/20250607.pdf
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AT tianyuyao acanthamoebakeratitisinatertiaryreferralhospitalincentralchinademographicsriskfactorsclinicalpresentationtreatmentsandoutcomes
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