Acanthamoeba keratitis in Porto Alegre (southern Brazil): 28 cases and risk factors

Parasitol Res. 2018 Mar;117(3):747-750. doi: 10.1007/s00436-017-5745-y. Epub 2018 Jan 14.

Abstract

The increasing use of contact lenses worldwide has led to an increase in cases of Acanthamoeba keratitis, which are often associated with inappropriate cleaning of contact lenses and lens cases. This study aimed to retrospectively review 28 cases of Acanthamoeba keratitis in Porto Alegre (southern Brazil) and identify the risk factors and clinical outcomes of affected patients. Most patients had higher education (66.6%), all were users of contact lenses, mostly women (67.9%). Most patients were soft contact lens wearers (66.7%) and 85.7% used multipurpose cleaning solutions. Sixteen patients (64.0%) used to wear contact lenses while swimming and/or bathing. Pain was the most common symptom (92.6%). For treatment, patients used polyhexamethylene biguanide drops (92.6%), propamidine isethionate drops (81.5%), chlorhexidine drops (55.6%), topical corticosteroids (63.0%), and systemic corticosteroids (37.0%). Herpes simplex keratitis was the most common misdiagnosis (72.7%). The majority of patients (76.0%) underwent a corneal transplant to control the disease.

Keywords: Acanthamoeba; Contact lenses; Corneal transplantation; Keratitis.

MeSH terms

  • Acanthamoeba Keratitis / diagnosis
  • Acanthamoeba Keratitis / epidemiology
  • Acanthamoeba Keratitis / etiology*
  • Acanthamoeba Keratitis / therapy
  • Adult
  • Benzamidines / therapeutic use
  • Biguanides / therapeutic use
  • Brazil / epidemiology
  • Chlorhexidine / therapeutic use
  • Contact Lens Solutions
  • Contact Lenses / adverse effects
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome

Substances

  • Benzamidines
  • Biguanides
  • Contact Lens Solutions
  • polihexanide
  • propamidine isethionate
  • Chlorhexidine