Acanthamoeba Keratitis In Saudi Arabia: A 34-Year Case Review

 

To report the demographics, potential predisposing factors, presentation and outcomes of Acanthamoeba keratitis (AK) at a tertiary eye hospital in Riyad, Saudi Arabia over a 34-year period.

The Acanthamoeba species was first reported to cause keratitis in 1973. Since then the incidence of AK has been increasing, this has been attributed to increased contact lens wear and improved diagnostic yield.The incidence varies significantly in different population groups and is estimated to be 1–2 per million contact lens wearers in the United States. The majority of AK occurs in CL wearers, with poor lens hygiene and water exposure the leading risk factors.

A retrospective review of all patients diagnosed or referred with AK at the King Khaled Eye Specialist Hospital (KKESH), Riyadh, Saudi Arabia between November 1983 and December 2017 was conducted. 

A total of 52 patients with AK at the tertiary referral hospital in Riyadh, Saudi Arabia, between November 1983 and December 2017, were included. The most commonly documented potential predisposing factors were contact lens wear (84.6%). Most of the patients received different treatment before referral (76.9%).  An initial misdiagnosis of herpetic eye disease was made in (32.5 %) of patients. The presenting clinical features based on clinical stage, mild stage (36.5%). The advanced stage (63.5%). Rate of failure was (61.5%) which defined as having a best-corrected visual acuity (BCVA) worse than 20/100 and/or requiring keratoplasty.  Four patients experienced recurrences (7.7%) of AK and one of them developed a scleritis. 

 

AK occurred predominantly in contact lens wearers with typical clinical features. The patient demographics, potential predisposing factors and clinical presentation of AK were similar to case series of different similar studies. The need of simple and timeline guideline of managing microbial keratitis will help in early diagnosis and proper management then better prognosis of such cases specially challenging cases of AK.