Acanthamoeba keratitis: multicentre survey in England 1992-6

Abstract

Conclusions-Earlier diagnosis and more eVective medical therapy have improved the prognosis for most AK patients. The study demonstrates the highly preventable nature of the disease: 91% of the SCL wearers could have avoided the disease by refraining from inadvisable practices, and a marked fall in frequency was seen after intensive media attention to AK, possibly in conjunction with increasing penetrance of new CL products. Since the frequency of AK appears to be largely determined by the ever changing trends in CL use, continued monitoring is indicated.

Visual outcome in Japanese patients with Acanthamoeba keratitis

“…This rate of positivity was similar to those in earlier reports. 1,3,6,7 Herpes simplex virus keratitis was the most common misdiagnosis, 4 which may reflect the similarity between this disease and typical nonspecific findings early in the course of AK, including epithelial microabrasion, irregularities, pseudodendritic lesions, and subepithelial infiltrates. All patients used contact lenses, and the majority used soft disposable lenses.…”

“…[1][2][3][4][5] However, specific treatment is not established, and there are some differences in the treatment between Western and Asian countries. In Japan, anti-fungal agents, corneal scraping, chlorhexidine gluconate (CHG), or some combination of these therapies are often used to treat AK.…”

“…However, polyhexamethyl biguanide (PHMB) and propamidine isethionate are often used in Western countries. 1,4,[6][7][8] Biguanides such as CHG and PHMB are the most effective cysticidal antiamoebics, and are currently used as a firstline treatment for AK. 9 Lim et al 10 compared the therapeutic outcomes for PHMB and CHG treatment and reported that, although the results were non-significant, 78% of eyes receiving PHMB and 86% of eyes receiving CHG were successfully treated.…”

Pathogenesis of microbial keratitis

“…This treatment is then reduced to 2-hourly application during the day for the next 3-4 weeks and then gradually tailored depending on the individual case. Treatment regimes on average last over a period of 6 months, ranging from 0.5 to 29 months [152].…”

Diagnosis of Acanthamoeba keratitis

“…Потенциальным источ-ником инфекции являются загрязненные контейне-ры для КЛ [24]. При обследовании в течение 4 лет у 243 больных АК выделены следующие основные причины, способствующие возникновению заболе-вания: нарушение режима очистки линз (62%), пла-вание с КЛ (34%), нарушение стерильности раство-ра по уходу за линзами (8%) [25].…”