Daas, L., Szentmary, N., Eppig, T., Langenbucher, A., Hasenfus, A., Roth, M., Saeger, M., Noelle, B., Lippmann, B., Boehringer, D., Reinhard, T., Kelbsch, C., Messmer, E., Pleyer, U., Roters, S., Zhivov, A., Engelmann, K., Schrecker, J., Zumhagen, L., Thieme, H., Darawsha, R., Meyer-ter-Vehn, T., Dick, B., Goersch, I., Hermel, M., Kohlhaas, M. and Seitz, B. (2015). The German Acanthamoeba keratitis register. Initial results of a multicenter study. Ophthalmologe, 112 (9). S. 752 - 764. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0423

Full text not available from this repository.

Abstract

Background and purpose. In September 2011 the cornea section of the German Ophthalmological Society (DOG) established the first German Acanthamoeba keratitis registry. The data of this multicenter survey are being collected, compiled and evaluated at the Department of Ophthalmology at the Saarland University. The aim of this article is to present an intermediate report. Patients and methods. Data from 172 eyes with Acanthamoeba keratitis were collected during the last 10 years. For this interim report we actually evaluated 121 eyes (60.2 % female patients, average age 41.3 years) and collected the following data: date of onset of symptoms, date and method of diagnosis, initial diagnosis, anamnestic data, clinical symptoms and signs at diagnosis and during follow-up, conservative and surgical therapy. Criteria for inclusion in the Acanthamoeba registry was the established diagnosis of an Acanthamoeba keratitis with at least one of the methods described in this article. Results. Acanthamoeba keratitis could be histologically proven in 55.3 % of the cases, via PCR in 25.6 %, with confocal microscopy in 20.4 % and using in vitro cultivation in 15.5 %. Clinical symptoms and signs in Acanthamoeba keratitis were pain in 67.0 %, ring infiltrates in 53.4 %, pseudodendritiform epitheliopathy in 11.7 % and keratoneuritis in 5.8 %. In 47.6 % of the cases the initial diagnosis was herpes simplex virus keratitis followed by bacterial keratitis in 25.2 % and fungal keratitis in 3.9 %. Acanthamoeba keratitis was the correct initial diagnosis in only 23.2 % of cases. The average time period between first symptoms and diagnosis was 2.8 +/- 4.0 months (range 0-23 months). A triple therapy with BroleneA (R) LavaseptA (R) and antibiotic eye drops at least 5 x/day was used in 54.5 % of eyes (n = 66). Penetrating keratoplasty was performed in 40.4 %, in 18 cases in combination with cryotherapy of the cornea. The mean graft diameter was 7.9 A +/- 1.1 mm (range 3.5-11.0 mm). The final visual acuity (Snellen visual acuity chart at 5 m) was comparable in the two groups of eyes with (5/40 A +/- 5/25) and without (5/32 A +/- 5/25) keratoplasty. Conclusion. Acanthamoeba keratitis is a rare and often very late diagnosed disease and two thirds of the cases were initially misdiagnosed. The early recognition of the typical symptoms is crucial for the prognosis of the disease. All ophthalmological departments in Germany are invited to submit further data of all confirmed cases (berthold.seitz@uks.eu), whether retrospectively or prospectively in order to generate an adequate standardized diagnostic and therapeutic approach for this potentially devastating disease.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Daas, L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Szentmary, N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eppig, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Langenbucher, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hasenfus, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roth, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Saeger, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Noelle, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lippmann, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boehringer, D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reinhard, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kelbsch, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Messmer, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pleyer, U.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roters, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zhivov, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Engelmann, K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schrecker, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zumhagen, L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thieme, H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Darawsha, R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meyer-ter-Vehn, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dick, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goersch, I.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hermel, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kohlhaas, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seitz, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-394381
DOI: 10.1007/s00347-014-3225-7
Journal or Publication Title: Ophthalmologe
Volume: 112
Number: 9
Page Range: S. 752 - 764
Date: 2015
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1433-0423
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
PENETRATING KERATOPLASTY; CLINICAL CHARACTERISTICS; DIAGNOSIS; EPIDEMIOLOGY; INFECTIONS; ENGLAND; AGENTS; SPP.; EYEMultiple languages
OphthalmologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/39438

Downloads

Downloads per month over past year

Altmetric

Export

Actions (login required)

View Item View Item