Bilateral &lt;i&gt;Acanthamoeba&lt;/i&gt; Keratitis in a Gas-Permeable Contact Lens Wearer

Giovannini, A.; Tittarelli, R; Bertelli, Enrico; Gb, Frongia; Mariotti, Cesare; Manso, E; Biavasco, Francesca

doi:10.1159/000310530

Cited by 8 publications

(4 citation statements)

References 11 publications

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“…Bilateral AK is relatively rare with only a few reported cases in the literature all noting associated CL use . Most case reports of bilateral AK were associated with soft CL use with the largest case series involving bilateral AK in five patients in the USA, however, one case has been previously reported involving rigid gas permeable CLs . Although the risk of AK may be higher with certain types of CLs such as first generation silicone hydrogel CLs, CLs of any sort constitute a significant risk factor for AK and include cosmetic and orthokeratology CLs as evidenced by the single case of cosmetic‐CL related AK noted in the current study.…”

Section: Discussionmentioning

confidence: 99%

The rising tide of Acanthamoeba keratitis in Auckland, New Zealand: a 7‐year review of presentation, diagnosis and outcomes (2009–2016)

McKelvie

Alshiakhi

Ziaei

et al. 2018

Clinical Exper Ophthalmology

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Section: Discussionmentioning

confidence: 99%

The rising tide of Acanthamoeba keratitis in Auckland, New Zealand: a 7‐year review of presentation, diagnosis and outcomes (2009–2016)

McKelvie

Alshiakhi

Ziaei

et al. 2018

Clinical Exper Ophthalmology

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“…In Italy the first report of Acanthamoeba human infection dates back to the 1990s in one HIV-positive patient with meningoencephalitis [14], followed by a clinical case of one patient with bilateral keratitis [15,16]. A few years later three cases of Acanthamoeba keratitis associated with the use of contact lenses were reported by Mancino et al [17].…”

Section: Introductionmentioning

confidence: 99%

Acanthamoeba T4 and T15 genotypes associated with keratitis infections in Italy

Cave

Monno

Bottalico

et al. 2008

Eur J Clin Microbiol Infect Dis

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Thus far there is little data available concerning Acanthamoeba associated amoebic keratitis (AK) from Italy. In order to understand the incidence of Acanthamoeba in patients with ocular infections and to characterize the isolates at the molecular level, ocular specimens and contact lenses or lens case solutions from 140 patients were analysed by culture and by an 18S rRNA (Rns) genebased PCR method. Nineteen (13.6%) patients showed Acanthamoeba culture positive samples. Eleven out of the 14 genetically characterized isolates were assigned to the T4 genotype. Three isolates, two of them from patients with keratitis responding to specific anti-Acanthamoeba therapy, were identified as belonging to the T15 genotype. This finding represents the first association between the T15 genotype and human amoebic keratitis. PCR amplification of the 18S ribosomal DNA proved to be a sensitive method, potentially able to detect Acanthamoeba without the need of long culture incubation, and thus considerably useful for clinical applications.

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“… 4 , 8 To our knowledge, all cases of bilateral acanthamoeba keratitis have been associated with contact lens use. 1 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 Diagnosis is difficult clinically, as a wide array of corneal manifestations are possible. 3 , 4 , 5 This case describes a patient without a history of contact lens wear who had an atypical presentation of acanthamoeba keratitis, but with slit lamp examination findings suggestive of central toxic keratopathy (CTK).…”

Section: Introductionmentioning

confidence: 99%

Atypical presentation of acanthamoeba keratitis resembling central toxic keratopathy

Ward¹,

Hastings

Shmunes³

et al. 2022

American Journal of Ophthalmology Case Reports

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Purpose To describe an atypical case of acanthamoeba keratitis with positive in vivo confocal microscopy in a non-contact lens user who presented with signs and symptoms suggestive of central toxic keratopathy. Observations The patient presented with bilateral, though sequential, decreased visual acuity with mild pain. Examination showed stromal haze with corneal flattening and thinning without epithelial defects. Optical coherence tonometry of the right eye revealed an inverse dome-shaped appearance of the opacity and in-vivo confocal imaging showed double-walled cysts consistent with acanthamoeba. Corneal haze, stromal loss, resolved and visual acuity improved over time. Conclusion and importance Acanthamoeba is a rare cause of infectious keratitis that is most often associated with contact lens wear in developed countries. Typically, it presents with a unilateral decrease in visual acuity, photophobia, watering, and pain that is out of proportion to slit lamp examination findings. However, many atypical presentations have been reported in the literature. Consequently, it may be misdiagnosed, especially early in the course of the disease. This delay in diagnosis can lead to progressive ulceration and visual impairment. In addition, cyst formation can make eradication with anti-amoebic treatment especially difficult. Central toxic keratopathy is a non-inflammatory clinical syndrome of unknown etiology that is most often associated with excimer laser ablation, though other associated causes have been reported. It is characterized by a central or paracentral opacity with corneal stromal loss and resultant hyperopic shift. The opacification and stromal loss mostly resolve over the course of months with an improvement in visual acuity. This report may help physicians broaden their differential and correctly diagnose atypical presentations of amoebic infection.

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Bilateral <i>Acanthamoeba</i> Keratitis in a Gas-Permeable Contact Lens Wearer

Cited by 8 publications

References 11 publications

The rising tide of Acanthamoeba keratitis in Auckland, New Zealand: a 7‐year review of presentation, diagnosis and outcomes (2009–2016)

The rising tide of Acanthamoeba keratitis in Auckland, New Zealand: a 7‐year review of presentation, diagnosis and outcomes (2009–2016)

Acanthamoeba T4 and T15 genotypes associated with keratitis infections in Italy

Atypical presentation of acanthamoeba keratitis resembling central toxic keratopathy

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