Novel Effective Medical Therapy for Acanthamoeba Keratitis.
Journal
Eye & contact lens
ISSN: 1542-233X
Titre abrégé: Eye Contact Lens
Pays: United States
ID NLM: 101160941
Informations de publication
Date de publication:
01 May 2024
01 May 2024
Historique:
accepted:
19
02
2024
medline:
6
5
2024
pubmed:
6
5
2024
entrez:
6
5
2024
Statut:
aheadofprint
Résumé
To report first clinical use of novel medical treatment for Acanthamoeba keratitis. Interventional observational case series. Two patients with Acanthamoeba keratitis were unsuccessfully treated with polihexanide (PHMB) 0.02% and propamidine 0.1% for 6 weeks, then all were shifted in a compassionate use of PHMB 0.08% with novel standardized protocol. The postinterventional follow-up of patients was at least 7 months. PHMB 0.08% eyedrops in a novel standardized protocol improved infection resolution and led to complete healing of the lesion after 4 weeks in the two cases. Corneal opacities and neovascularization decreased slowly, best-corrected visual acuity slightly improved and progressively increased in the further 7 months, and no infection recurrence occurred. This preliminary report of two cases shows promising response to polihexanide 0.08% lowering drastically the illness duration, with reduced chance of recurrence, and mostly improving patients' quality of life.
Identifiants
pubmed: 38709240
doi: 10.1097/ICL.0000000000001092
pii: 00140068-990000000-00195
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Contact Lens Association of Opthalmologists.
Déclaration de conflit d'intérêts
The authors have no conflict of interest to declare.
Références
Dart JK, Saw VP, Kilvington S. Acanthamoeba keratitis: Diagnosis and treatment update 2009. Am J Ophthalmol 2009;148:487–499.e2.
Alkharashi M, Lindsley K, Law HA, et al. Medical interventions for acanthamoeba keratitis. Cochrane Database Syst Rev 2015;2015:CD010792.
Lorenzo-Morales J, Khan NA, Walochnik J. An update on Aacanthamoeba keratitis: Diagnosis, pathogenesis and treatment. Parasite 2015;22:10.
Varacalli G, Di Zazzo A, Mori T, et al. Challenges in acanthamoeba keratitis: A review. J Clin Med 2021;10:942.
Hammersmith KM. Diagnosis and management of Acanthamoeba keratitis. Curr Opin Ophthalmol 2006;17:327–331.
Dart J, Papa V, Rama P, et al. The orphan drug for acanthamoeba keratitis (ODAK) trial: PHMB 0.08% (polihexanide) and placebo versus PHMB 0.02% and propamidine 0.1%. Ophthalmology 2024;131:277–287.
Papa V, Van der Meulen I, Rottey S, et al. Safety and tolerability of topical polyhexamethylene biguanide: A randomised clinical trial in healthy adult volunteers. Br J Ophthalmol 2022;106:190–196.
Papa V, Rama P, Radford C, et al. Acanthamoeba keratitis therapy: Time to cure and visual outcome analysis for different antiamoebic therapies in 227 cases. Br J Ophthalmol 2020;104:575–581.
Lim N, Goh D, Bunce C, et al. Comparison of polyhexamethylene biguanide and chlorhexidine as monotherapy agents in the treatment of acanthamoeba keratitis. Am J Ophthalmol 2008;145:130–135.
Hargrave SL, McCulley JP, Husseini Z. Results of a trial of combined propamidine isethionate and neomycin therapy for Acanthamoeba keratitis. Brolene Study Group. Ophthalmology 1999;106:952–957.
Di Zazzo A, Varacalli G, De Gregorio C, et al. Therapeutic corneal transplantation in acanthamoeba keratitis: Penetrating versus lamellar keratoplasty. Cornea 2022;41:396–401.