The role of contact lenses and ocular TRAUMA in determining Acanthamoeba Keratitis: a case-control study in Italy

Authors

  • Elena Pacella Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
  • Fernanda Pacella epartment of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
  • David Impallara Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
  • Vittorio Scavella Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
  • Paolo Turchetti IHMP - National Institute for Health, Migration and Poverty Hospital of Rome, Italy
  • Carmen Piraino Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
  • Chiara Brillante Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
  • Anna Maria Lombardi Department of Public Health and Infectious Diseases, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Italy
  • Maria De Giusti Department of Public Health and Infectious Diseases, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Italy

DOI:

https://doi.org/10.2427/5634

Keywords:

Keratitis, Acanthamoeba, Contact lens, TRAUMA

Abstract

Background: acanthamoeba keratitis (a.k.) is a rare secondary infection due to acanthamoeba (a)
invading the cornea. cofactors of risk may include TrauMa and contact lenses (cL). The objectives of
this observational study are to evaluate the occurrence of a.k. in patients accessing the department
of Special Senses of the Teaching Hospital “Policlinico umberto I” of rome with ocular infections dur-
ing the period from 2005 to 2011, and the role played by risk factors which included contact lenses,
TrauMa, sex and age.
MeTHodS: a case-control study involving 714 subjects was conducted (350 male and 364 female). all of
the patients underwent a thorough ocular examination with confocal microscopy and a review of their
medical history to outline relevant variables (contact lens and TrauMa). Statistical analysis calculated
the frequency distribution and the odds ratio (or) (95%cI) for the risk factors “contact lenses” (cL) and
“TrauMa”. The odds ratio (95%cI) was adjusted for age and sex trough Logistic regression.
reSuLTS: out of 714 patients, 11 patients (7 male and 4 female) with a mean age of 34.09 years (19 to 51
years old) were found to be affected by a.k. The age group most afflicted ranged from 30 to 51 years old.
Statistical analysis produced a crude or equal to 17.68 (95%cI 2.25-138.89) for cL-a.k. and or equal
to 7.71 (95%cI 0.89-66.75) for ocular TrauMa.-a.k. Logistic regression performed to adjust or for age
and sex showed the following values, respectively: or*=82.54 (95%cI 3.04-2239.58) and or*=11.52
(95%cI 1.19-111.76).
concLuSIonS: The data highlights an increase in a.k. cases during the 6 year study period. The
association between this pathology and the use of contact lenses and/or TrauMa has been statisti-
cally proven. The strength of this association increases when the odds ratio (or*) is adjusted for the
confounding risk factors of age and sex. When dealing with the topic of acanthamoeba keratitis, it is
important to remember that educating patients on proper hygiene practice for contact lenses is the first
step towards preventing a.k. The results obtained are important because they are derived from the first
Italian case-control study on a.k.

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Published

2012-03-31

Issue

Vol. 9 No. 1 (2012)

Section

Articles