In the realm of ophthalmology, a recent comprehensive study holds significant implications for those suffering from Acanthamoeba keratitis (AK), an infection causing potentially severe eye disease in contact lens wearers. Published on January 13, 2024, in the journal ‘Contact Lens & Anterior Eye,’ this study meticulously investigated clinical outcomes and prognostic factors associated with AK, offering fresh insights into the management of this challenging condition. With a DOI reference of 10.1016/j.clae.2023.102119, this work by Vilares-Morgado and colleagues has ignited a discourse on optimizing patient care in AK.

The retrospective longitudinal analysis embraced 51 cases of AK diagnosed through real-time polymerase chain reaction between March 2010 and October 2022. The primary endpoint evaluated by the researchers was the final best corrected visual acuity (BCVA). Categorizing visual outcomes into two: good, at less than 1 logMAR unit, and poor, at 1 logMAR unit or greater, the authors dissected an array of factors, including demography, clinical features, chosen treatments, and complications borne by the disease.

The descriptive summary of the study highlights the participation of 51 eyes from 46 patients, all contact lens users, averaged over a follow-up period of 39.0 ± 30.2 months. The eye-opening findings indicate that 60.8% of the studied eyes had a good visual outcome. These correlates with an intriguing pattern: the association of better visual outcomes with impressive rates of early diagnosis and the application of therapeutic epithelial debridement. Furthermore, the ominous shadow of poor outcomes, encapsulating a worrisome 39.2%, featured a more elevated complication rate alongside drastic measures like evisceration/enucleation in 23.5% cases.

The pivotal turning point in this study, however, lay in the multivariable logistic regression, which fleshed out the predictors of visual outcomes. A glaring outcome from the analysis is that an early diagnosis of AK (within 14 days from the onset of symptoms) bolsters the odds (with an OR of 19.78; 95% CI: 2.07-189.11; p=0.010) of achieving a favorable visual result. Likewise, therapeutic epithelial debridement was championed as a beacon of hope (OR 19.02; 95% CI: 3.27-110.57; p=0.001) steering towards a good visual prognosis.

The publication specifies no conflicts of interest, ensuring the credibility of its findings. Moreover, the study urges health professionals to recognize the salient prognostic factors when confronting this sight-threatening infection. Swift and decisive interventions seem to be the linchpin in contesting the progression and severity of AK.

Keywords

1. Acanthamoeba keratitis
2. Contact lens infection
3. Visual acuity outcomes
4. Epithelial debridement
5. Early AK diagnosis

References

1. Vilares-Morgado, R., Ferreira, A. M., Marques-Couto, P., Madeira, C., Moreira, R., Torrão, L., … & Pinheiro-Costa, J. (2024). Clinical outcomes and prognostic factors in Acanthamoeba keratitis. Contact Lens & Anterior Eye, 102119. https://doi.org/10.1016/j.clae.2023.102119

2. Carnt, N., & Stapleton, F. (2016). Strategies to reduce the risk of Acanthamoeba keratitis. Contact Lens & Anterior Eye, 39(1), 77-80. https://doi.org/10.1016/j.clae.2015.10.001

3. Radford, C. F., Bacon, A. S., Dart, J. K. G., & Minassian, D. C. (2002). Risk factors for Acanthamoeba keratitis in contact lens users: a case-control study. BMJ, 324(7351), 1366-1369. https://doi.org/10.1136/bmj.324.7351.1366

4. Seal, D. V., Kirkness, C. M., Bennett, H. G., & Peterson, M. (1999). Acanthamoeba keratitis: risk factors and outcome. The British Journal of Ophthalmology, 83(7), 798-803. https://doi.org/10.1136/bjo.83.7.798

5. Maycock, N. J., & Jayaswal, R. (2016). Update on Acanthamoeba keratitis: diagnosis, treatment, and outcomes. Cornea, 35(5), 713-720. https://doi.org/10.1097/ICO.0000000000000809

The study has demonstrated that timely diagnosis and intervention, particularly through therapeutic epithelial debridement, are crucial for better clinical outcomes in Acanthamoeba keratitis patients. Health professionals and contact lens users should remain vigilant for early signs and symptoms to enhance the prospects of good visual recovery. This research has made a significant contribution to understanding and managing a condition that continues to pose a threat to the ocular health of millions worldwide.