Purpose: To evaluate the outcome of Acanthamoeba keratitis with respect to the delay in diagnosis Methods: A retrospective review of the records of 14 patient s treated for A canthamoeba keratitis was carried out. Del...Purpose: To evaluate the outcome of Acanthamoeba keratitis with respect to the delay in diagnosis Methods: A retrospective review of the records of 14 patient s treated for A canthamoeba keratitis was carried out. Delay in diagnosis was co rrelated with risk factors, clinical presentation, method of diagnosis, final vi sual acuity and need for penetrating keratoplasty. Results: Based on the time in terval between the first symptoms and the diagnosis of Acanthamoeba keratitis, i t appeared that patients could be divided into two groups: an early treatment gr oup (group I), consisting of six patients treated within 18 days of onset of sym ptoms, and a late treatment group (group II), composed of eight patients treated beyond that time. There were no statistically significant differences between t he two groups as far as risk factors, clinical presentation, accuracy of diagnos iof and method of diagnosis were concerned, although more extensive and deeper c orneal involvement was noted in group II. Improvement in visual acuity following medical therapy was seen in all six patients in the early group and in three (3 7%) of the eight patients in the late group. One patient in group I needed urge nt penetrating keratoplasty for corneal necrosis. In group II, two patients unde rwent penetrating keratoplasty chaud to prevent corneal perforation and three patients needed penetrating keratoplasty to restore functional visual acuity. Co nclusion: A diagnostic delay of less than 18 days between onset of symptoms and start of anti-amoebic treatment results in a better final VA after medical trea tment and obviates the need for urgent and elective penetrating keratoplasty.展开更多
文摘Purpose: To evaluate the outcome of Acanthamoeba keratitis with respect to the delay in diagnosis Methods: A retrospective review of the records of 14 patient s treated for A canthamoeba keratitis was carried out. Delay in diagnosis was co rrelated with risk factors, clinical presentation, method of diagnosis, final vi sual acuity and need for penetrating keratoplasty. Results: Based on the time in terval between the first symptoms and the diagnosis of Acanthamoeba keratitis, i t appeared that patients could be divided into two groups: an early treatment gr oup (group I), consisting of six patients treated within 18 days of onset of sym ptoms, and a late treatment group (group II), composed of eight patients treated beyond that time. There were no statistically significant differences between t he two groups as far as risk factors, clinical presentation, accuracy of diagnos iof and method of diagnosis were concerned, although more extensive and deeper c orneal involvement was noted in group II. Improvement in visual acuity following medical therapy was seen in all six patients in the early group and in three (3 7%) of the eight patients in the late group. One patient in group I needed urge nt penetrating keratoplasty for corneal necrosis. In group II, two patients unde rwent penetrating keratoplasty chaud to prevent corneal perforation and three patients needed penetrating keratoplasty to restore functional visual acuity. Co nclusion: A diagnostic delay of less than 18 days between onset of symptoms and start of anti-amoebic treatment results in a better final VA after medical trea tment and obviates the need for urgent and elective penetrating keratoplasty.
