Alreshidi Shaker Osaywid, Vargas José Manuel, Ahmad Khabir, Alothman Ahmed Yousef, Albalawi Eman D, Almulhim Abdulmohsen, Alenezi Saad Hamdan, ALBalawi Hani Basher, Alali Naif Mamdouh, Hashem Faris, Aljindan Mohanna
Ophthalmology Department, College of Medicine, Majmaah University, Majmaah, Saudi Arabia.
Cornea, External Diseases Section, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
PLoS One. 2024 Mar 12;19(3):e0299492. doi: 10.1371/journal.pone.0299492. eCollection 2024.
Infectious Keratitis is one of the most common ocular emergencies seen by ophthalmologists. Our aim is to identify the risk factors and clinical features of Acanthamoeba Keratitis (AK).
This retrospective chart review study was conducted at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, and included all the microbial keratitis cases, male and female patients of all ages. The main outcome is the differentiation between various microbial keratitis types.
We included 134 consecutive eyes of 126 persons. We had 24 cases of acanthamoeba keratitis, 22 bacterial keratitis, 24 fungal keratitis, 32 herpetic keratitis, and 32 bacterial co-infection. Contact lens wear was found in 33 eyes (24.6%). Among acanthamoeba keratitis patients, 73% were ≤ 39 years of age, and 73% were females (P <0.001). Also, in AK cases, epithelial defect was found in all cases (100%), endothelial plaques were found in 18 eyes (69.2%), 12 cases had radial keratoneuritis (46.2%), and ring infiltrate was found in 53.8% of AK cases.
We determined the factors that increase the risk of acanthamoeba infection and the clinical characteristics that help distinguish it from other types of microbial keratitis. Our findings suggest that younger females and patients who wear contact lenses are more likely to develop acanthamoeba keratitis. The occurrence of epitheliopathy, ring infiltrate, radial keratoneuritis, and endothelial plaques indicate the possibility of acanthamoeba infection. Promoting education on wearing contact lenses is essential to reduce the risk of acanthamoeba infection, as it is the most significant risk factor for this infection.
感染性角膜炎是眼科医生最常遇到的眼部急症之一。我们的目的是确定棘阿米巴角膜炎（AK）的危险因素和临床特征。
这项回顾性病历审查研究在沙特阿拉伯利雅得的哈立德国王眼科专科医院进行，纳入了所有微生物性角膜炎病例，涵盖各年龄段的男性和女性患者。主要结果是区分各种微生物性角膜炎类型。
我们纳入了126人的134只连续眼睛。其中有24例棘阿米巴角膜炎、22例细菌性角膜炎、24例真菌性角膜炎、32例疱疹性角膜炎以及32例细菌合并感染。33只眼睛（24.6%）有佩戴隐形眼镜史。在棘阿米巴角膜炎患者中，73%年龄≤39岁，73%为女性（P<0.001）。此外，在AK病例中，所有病例（100%）均有上皮缺损，18只眼睛（69.2%）发现内皮斑块，12例（46.2%）有放射状角膜神经炎，53.8%的AK病例有环形浸润。
我们确定了增加棘阿米巴感染风险的因素以及有助于将其与其他类型微生物性角膜炎区分开来的临床特征。我们的研究结果表明，年轻女性和佩戴隐形眼镜的患者更易发生棘阿米巴角膜炎。上皮病变、环形浸润、放射状角膜神经炎和内皮斑块的出现提示有棘阿米巴感染的可能。由于佩戴隐形眼镜是这种感染的最重要危险因素，因此开展佩戴隐形眼镜的教育对于降低棘阿米巴感染风险至关重要。
