title: Acanthamoeba keratitis: 10-year study at a tertiary eye care center in Hong Kong.
abstract: OBJECTIVE
  To review clinical presentation, investigation results and treatment outcomes of patients with Acanthamoeba keratitis (AK) at a tertiary eye care center in Hong Kong.
  
  
  METHODS
  A retrospective case review was performed for cases of Acanthamoeba keratitis diagnosed at the Prince of Wales Hospital, Hong Kong over a 10-year period.
  
  
  RESULTS
  Fifteen eyes of 13 patients were treated for AK over the study period. 12 out of 13 patients (92.3%) were contact lens wearers. All patients presented with blurred vision and pain, while 9 patients (69.2%) presented with redness of the affected eye. The most common ocular sign was diffuse corneal haze or ground glass appearance of the cornea (69.2%) followed by anterior chamber inflammation (53.8%), ring infiltrate (38.4%), epithelial defect (38.4%), perineural infiltrates (30.7%) and satellite lesions (15.3%). Acanthamoeba was detected on corneal scrapings in 4 eyes and on confocal microscopy in 4 eyes. The mean duration of treatment was 140 ± 50.8 days. Surgical intervention was required in two cases due to uncontrolled eye infection and progressive corneal thinning. All patients had improvement in visual acuity after treatment.
  
  
  CONCLUSIONS
  Patients with AK exhibited a wide spectrum of clinical characteristics. Improper care and usage of contact lenses is a major risk factor for Acanthamoeba keratitis. Diagnosis of AK remained a challenge. Timely diagnosis and appropriate treatment with amoebicidal drugs can improve the outcomes of Acanthamoeba keratitis.
authors.affiliation: Department of Ophthalmology, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Joyce
authors.initials: J
authors.lastname: Chin
authors.affiliation: Department of Ophthalmology, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Alvin L
authors.initials: AL
authors.lastname: Young
authors.affiliation: Department of Microbiology, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Mamie
authors.initials: M
authors.lastname: Hui
authors.affiliation: Department of Ophthalmology, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: vishaljhanji@gmail.com.
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
mesh_terms: D015823:Acanthamoeba Keratitis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D003261:Contact Lenses / Q000009:adverse effects* / Q000469:parasitology*; D058447:Eye Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006723:Hong Kong; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods; D013508:Ophthalmologic Surgical Procedures / Q000379:methods; D009887:Ophthalmoscopy / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acanthamoeba keratitis; Keratitis; Outcome; Treatment