Topical corticosteroids in Acanthamoeba keratitis: Friend or foe?

Background/Aims: To analyse the effect of topical corticosteroids before start of anti-amoebic therapy (AAT) in Acanthamoeba keratitis (AK) on final visual outcome and to identify factors that affect the outcome. Methods: A retrospective case control study of the medical records of patients diagnosed with AK at the Rotterdam Eye Hospital between 2003 and 2017 was performed. Patient demographic and clinical data were collected. The outcomes of patients treated with topical corticosteroids before the start of AAT were compared with those not treated with topical corticosteroids. Univariable and multivariable analyses were conducted. Results: A total of 109 patients was diagnosed with AK, with a mean follow-up time of 18 months. The use of corticosteroids was associated with a delay in diagnosis and thereby the start of AAT. In the non-steroids group, mean diagnostic delay was 23 days versus 62 days in the steroids group (p