University Hospital Coventry & Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX, United Kingdom.
University Hospital Coventry & Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX, United Kingdom.
Cont Lens Anterior Eye. 2019 Oct;42(5):506-511. doi: 10.1016/j.clae.2019.04.009. Epub 2019 Apr 22.
To report an observational study of Acanthamoeba Keratitis (AK) in University Hospital Coventry & Warwickshire (UHCW), Coventry, UK and determine risk factors, outcomes as well as incidence rates.
A retrospective analysis was done of consecutive patients who were treated for AK by the corneal service at UHCW from January 2017 to January 2018. Cases were identified from 2 sources; the department of microbiology and the hospital pharmacy. Patient data was collected by 3 of the authors using both paper and electronic medical records. Information was also gathered over the telephone using a predefined questionnaire. The primary endpoint used for assessing duration of disease was time to resolution after the initial diagnosis.
9 eyes were identified over the 12-month period, a drastic increase from previous years. All were contact lens (CL) wearers and 3 used daily disposable CL's. 8 out of 9 patients had an improvement in best corrected visual acuity (BCVA) which was consistent with their baseline levels pre-infection. The average length of treatment was 107.25 days for the 8 resolved cases. 1 case is still having ongoing treatment. No case has required surgical treatment. Several patients admitted to exposing their CL to unsterile water either via swimming, showering or tap water. All patients had purchased their lenses from contact lens practitioners.
Overall, our study shows excellent outcomes. Almost all patients had resolution of symptoms with medical treatment and an improvement in visual acuity. Several contributing factors have aided us in achieving this including early diagnosis, a robust treatment protocol and diagnostic modalities such as Polymer Chain Reaction (PCR) and Confocal Microscopy (CFM). However, the increased incidence compared to previous years is a worrying trend and there will be an ongoing analysis looking at patterns of incidence in the future.
报告英国考文垂和沃里克郡大学医院（UHCW）的棘阿米巴角膜炎（AK）观察性研究，确定危险因素、结局和发病率。
对 2017 年 1 月至 2018 年 1 月期间 UHCW 角膜科治疗的 AK 连续患者进行回顾性分析。病例从 2 个来源确定：微生物学部和医院药房。由 3 位作者使用纸质和电子病历收集患者数据。还通过预定义的问卷通过电话收集信息。用于评估疾病持续时间的主要终点是初始诊断后缓解的时间。
在 12 个月期间发现 9 只眼睛，与前几年相比急剧增加。所有患者均为隐形眼镜（CL）佩戴者，其中 3 人使用日抛型 CL。9 名患者中有 8 名患者的最佳矫正视力（BCVA）得到改善，与感染前的基线水平一致。8 例治愈患者的平均治疗时间为 107.25 天。1 例仍在接受治疗。没有患者需要手术治疗。一些患者承认将 CL 暴露于未经消毒的水中，无论是游泳、淋浴还是自来水。所有患者均从隐形眼镜从业者处购买了镜片。
总体而言，我们的研究显示出良好的结果。几乎所有患者都通过药物治疗和视力改善缓解了症状。有几个促成因素帮助我们实现了这一目标，包括早期诊断、强大的治疗方案以及聚合酶链反应（PCR）和共聚焦显微镜（CFM）等诊断方法。然而，与前几年相比，发病率的增加是一个令人担忧的趋势，未来将进行持续分析，以了解发病率的模式。
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