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Eye Contact Lens. 2018 Sep;44 Suppl 1:S173-S178. doi: 10.1097/ICL.0000000000000365.

Risk Factors for Acanthamoeba Keratitis-A Multistate Case-Control Study, 2008-2011.

Author information

1
National Center for Emerging and Zoonotic Infectious Diseases (A.C.B., J.R., S.C., T.L.A., R.M.H., S.L.R., M.J.B., and J.S.Y.), Centers for Disease Control and Prevention, Atlanta, GA; Department of Ophthalmology (D.B.J.), Baylor College of Medicine, Houston, TX; and New York State Department of Health (B.B.), Albany, NY.

Abstract

OBJECTIVE:

To identify modifiable risk factors contributing to Acanthamoeba keratitis (AK) infection.

METHODS:

A case-control investigation was conducted. Case patients were soft contact lens wearers with laboratory-confirmed AK. Control were soft contact lens wearers ≥12 years of age, with no history of AK. Case patients were recruited from 14 ophthalmology referral centers and a clinical laboratory. Control were matched on state of residence and type of primary eye care provider (ophthalmologist or optometrist). Participants were interviewed using a standardized questionnaire. Univariable and multivariable conditional logistic regression analyses were conducted. Matched odds ratios (mORs) were calculated.

RESULTS:

Participants included 88 case patients and 151 matched control. Case patients were more likely to be aged <25 years (unadjusted mOR 2.7, 95% confidence interval 1.3-5.5) or aged >53 years (mOR 2.5, 1.1-5.7), and more likely to be men (mOR 2.6, 1.4-4.8). Unadjusted analyses identified multiple risk factors: rinsing (mOR 6.3, 1.3-29.9) and storing lenses in tap water (mOR 3.9, 1.2-12.3), topping off solution in the lens case (mOR 4.0, 2.0-8.0), having worn lenses ≤5 years (mOR 2.4, 1.3-4.4), rinsing the case with tap water before storing lenses (mOR 2.1, 1.1-4.1), and using hydrogen peroxide (mOR 3.6, 1.1-11.7) versus multipurpose solution. Significant risk factors in multivariable modeling included age >53 years, male sex, topping off, and using saline solution.

CONCLUSIONS:

Numerous modifiable risk factors for AK were identified, mostly involving hygiene practices. To reduce the risk of AK, lens wearers should observe recommended lens care practices.

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