Analysis from a year of increased cases of Acanthamoeba Keratitis in a large teaching hospital in the UK

Hassan, Faaiq; Bhatti, Ahsan; Desai, R. S.; Barua, Ankur

doi:10.1016/j.clae.2019.04.009

Cited by 22 publications

(19 citation statements)

References 28 publications

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“…22 Jain et al noted in 2015 that the incidence of AK is lower in developing when compared with developed countries. In the latter, the majority of cases are linked with the use of CLs, 85 specifically soft CLs 75,86 in 85-88% of cases, 13,38,50 even though it can be present with rigid 31 and orthokeratology lenses. 79 The diagnosis is often late due to its low incidence (around 3-15%) in the UK and USA.…”

Section: Incidencementioning

confidence: 99%

Acanthamoeba keratitis: a review of biology, pathophysiology and epidemiology

Lacerda

Lira

2020

Ophthalmic Physiologic Optic

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Acanthamoeba keratitis is an infection caused by a unicellular protozoan of the genus Acanthamoeba that is universally widespread. Until now, most cases were reported in contact lens wearers, although it is also a reality for non‐wearers, mostly connected to corneal trauma. There is also a variation in incidence regarding the aetiology of the disease between developed and developing countries. Purpose This work is based on a literature review, and the main goal is to deepen the knowledge about Acanthamoeba keratitis, presenting the main risk factors and focusing on prevention actions for this type of corneal infection since the treatments are not always effective. It targets specialists in visual health to strengthen their knowledge in this area, as well as to allow them to better inform their patients about hygiene care, appropriate measures of disinfection and ways to minimise the risk of infection. At this stage, it is important to highlight the essential role that practitioners play in fitting, monitoring and following‐up patients to minimise the danger of infection. Recent findings It is well recognised that corneal trauma facilitates invasion by leaving an open door for microorganisms to penetrate the cornea. In addition to trauma, risk factors are mostly associated with patients’ behaviours, such as interaction of contact lenses with contaminated water in the shower, swimming pools and beaches, etc., lack of hygiene habits with contact lenses and respective cases, and the use of ineffective disinfecting solutions. The fact that a disinfecting solution is not completely effective against trophozoites and/or cysts, both forms of Acanthamoeba’s lifecycle, can cause the infection since one cyst alone leads to the emergence of a whole new population of Acanthamoeba. Summary It is necessary to reduce the risk of infection and, beyond the need to promote patient education to encourage correct CL hygiene behaviours, it should also be highlighted that there is an urgent need to enhance the efficacy of CL disinfection systems against all strains and both stages of Acanthamoeba through the creation of standardised methods. The ease of purchasing CLs without any supervision must also be considered a concern, and, in the near future, it is also important to develop and implement effective diagnostic methods and treatments for Acanthamoeba keratitis.

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Section: Incidencementioning

confidence: 99%

Acanthamoeba keratitis: a review of biology, pathophysiology and epidemiology

Lacerda

Lira

2020

Ophthalmic Physiologic Optic

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“…However, many clinicians prefer a dual therapeutic plan by combining a biguanide with a diamidine for potentially synergistic or additive effects in consideration of the difficulty of eradicating resistant cysts. 10,56 Various researchers have compared the respective efficacy of these medications. 55,57,58 However, no significant difference has been found in the success rate (78% and 86% for chlorhexidine and polyhexamethylene biguanide, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…The formation of cataract or elevated intraocular pressure can be caused by severe anterior chamber inflammation, which can also be attributed to long-term use of topical antiamoebic eyedrops. 10,41 Numerous studies have suggested that a long symptom duration before diagnosis or a late stage of AK at presentation is associated with a longer disease course and worse visual outcome. 43,45,46 One main reason for the favorable prognosis in our patients was a timely diagnosis within the first few days of symptom occurrence.…”

Section: Discussionmentioning

confidence: 99%

Orthokeratology lens-related Acanthamoeba keratitis: case report and analytical review

Xie

2021

J Int Med Res

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Acanthamoeba keratitis (AK) is a rare but severe ocular infection with a significant risk of vision loss. Contact lens use is the main risk factor for AK. The orthokeratology (OK) lens, a specially designed contact lens, has been used worldwide as an effective method of myopia control. However, the OK lens is associated with an increased risk of Acanthamoeba infection. Many primary practitioners are concerned about this infection because of its relative rarity, the lack of promising therapeutic medications, and the need for referral. We herein report two cases of AK associated with OK lenses, present a systematic review of such cases, and discuss the possible reasons for the higher incidence rate of this infection in patients who wear OK lenses. We combined the clinical knowledge and skills of corneal specialists and lens experts with the sole objective of addressing these OK lens-related AK cases. We found that the most common risk factors were rinsing the lenses or lens cases with tap water. Prompt and accurate diagnosis along with adequate amoebicidal treatment are essential to ensure desirable outcomes for OK lens wearers who develop AK. Appropriate OK lens parameters and regular checkups are also important.

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“…This provides vital additional information for patients both in the acute and chronic stages of the disease process. IVCM applications range from early detection of microbial keratitis (Hassan et al, 2019), reduction in corneal after ophthalmic surgery (Recchioni et al, 2020), assessment of rare genetic diseases (Leonardi et al, 2020), dry eye screening and diagnosis (Hwang et al, 2021), etc. In the context of MG imaging, IVCM can observe fine details of the MG anatomical structure, which might suggest any abnormalities leading to MGD.…”

Section: In-vivo Confocal Microscopy (Ivcm)mentioning

confidence: 99%

Imaging the tarsal plate: A Mini-Review

Recchioni

2021

Scand J Optom Vis Sci

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Imaging the tarsal plate and the meibomian glands (MG) grants new opportunities for ophthalmic practitioners who work in the field of the ocular surface and dry eye across the globe. The secretory role of MG plays a fundamental part in protecting the moisture in front of the eye surface by creating an active shield made of meibum (lipid) which prevents tear evaporation and causes dry eye. Evidence from the most popular Dry Eye Workshop reports (2007 and 2016) demonstrate that MG dysfunction is the first cause of evaporative dry eye which is also the most common cause of dry eye and ocular surface discomfort. Fortunately, during the last years, a plethora of new devices for MG observation, diagnosis and follow-up have been made available in the market. These devices range from invasive to minimally invasive, high to low-tech and from being expensive to low-cost. The objective of this mini-review is to condense the latest evidence in MG imaging by providing a narrative overview on the most common technologies plus some other newer aspects which might guide clinicians and researchers in the field of the ocular surface and dry eye.

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Analysis from a year of increased cases of Acanthamoeba Keratitis in a large teaching hospital in the UK

Cited by 22 publications

References 28 publications

Acanthamoeba keratitis: a review of biology, pathophysiology and epidemiology

Acanthamoeba keratitis: a review of biology, pathophysiology and epidemiology

Orthokeratology lens-related Acanthamoeba keratitis: case report and analytical review

Imaging the tarsal plate: A Mini-Review

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