Abstract
Purpose Acanthamoeba keratitis (AK) is a sight-threatening condition associated with contact lenses. Early diagnosis and therapy response assessment remain clinical challenges. Recent studies suggest that anterior segment optical coherence tomography (AS-OCT) can detect radial keratoneuritis RK) in AK. Despite this, it is unclear if the presence of RK or quantitative RK parameters are clinically useful. Using AS-OCT, we detected RK changes in patients with AK throughout their clinical course, from presenting symptoms to treatment resolution.
Methods A retrospective observational clinical study was conducted to assess changes in RK during the AK clinical course using AS-OCT. In 26 patients with confirmed AK on confocal microscopy or culture, serial AS-OCT imaging was performed at presentation and multiple time points until infection resolution. Measurements were taken at each visit to determine the length, width and depth of the RK.
Results 61.5% of patients had multiple inflamed nerves in the form of RK at presentation. There were 11 patients with complete clinical data series showing RK which were subsequently analysed. Mean RK length showed a significant decrease from 516 μm on day 0 (time of presentation) to 309 μm on day 111 (p=0.030). Mean RK width decreased from 64 μm (day 0) to 34 μm (day 111; p=0.016), and mean RK depth reduced from 421 μm (day 0) to 275 μm (day 111; p=0.002). The resolution of RK coincided with improvement of symptoms.
Conclusion This study provides additional evidence supporting the use of AS-OCT in detecting RK in patients with AK. The measurement of RK over time in AK offers an objective method for monitoring clinical response
