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10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits

 

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Audit on management of Acanthamoeba keratitis at University Hospitals Coventry and Warwickshire

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Session Details

Session Title: Presented Poster Session: Cross-linking

Session Date/Time: Sunday 11/09/2016 | 09:30-11:00

Paper Time: 10:50

Venue: Poster Village: Pod 3

First Author: : P.Garala UK

Co Author(s): :    V. Thakrar   M. Rana           

Abstract Details

Purpose:

Acanthamoeba keratitis (AK) is a potentially sight threatening condition. 92% of cases are seen in contact lens wearers. There are currently no Royal College of Ophthalmology guidelines on its management. Our aims were to identify the risk factors in our cohort, successful diagnosis, the efficacy of investigative tools and appropriate management.

Setting:

The audit was conducted in the Ophthalmology Unit, University Hospitals Coventry and Warwickshire.

Methods:

We retrospectively studied a cohort of 33 patients seen at University Hospitals of Coventry and Warwickshire between March’10 and May’15 who had been prescribed brolene, chlorhexidine or Polyhexamethylene biguanide (PHMB). We reviewed the risk factors, misuse, clinical findings, investigation, treatment and outcome.

Results:

13 of 33 patients treated with the above medication tested positive for AK, of who all wore contact lens, reinforcing that this is the biggest risk factor. Only 5 of these patients had both acanthamoeba PCR and culture performed, of which 2 cases were both culture and PCR positive. During the course of the condition, 5 patients were prescribed all three medications, 7 had a combination of two and 1 had just one. 8 patients were prescribed steroids within 2 weeks of presentation.

Conclusions:

The results indicate the importance of performing both PCR and culture on all suspects as performing one alone may not identify the organism. The range of regimes used identifies a lack of and requirement for a common protocol. Early use of steroids as in some of our cohort could result in rapid disease progression and reduction in visual outcome. A larger scale study would enable identification of management across other centres and could help create national guidelines for safer, standardised and consistent management of AK.

Financial Disclosure:

NONE

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