Accelerated collagen cross-linking in the management of advanced Acanthamoeba
            keratitis

Cartes, Cristián; Marco, Casas del Valle; Kantor, Arturo; Pérez, Carolina Alejandra; Srur, Miguel; Rolf, Raimann; Remigio, López; Traipe, Leonidas

doi:10.5935/0004-2749.20190018

Cited by 11 publications

(4 citation statements)

References 18 publications

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“…Some clinical studies reported interesting outcomes of epi-off CXL on acanthamoeba keratitis. [144,145] However, several in vitro studies have shown that riboflavin mediated CXL did not confer any positive effect on acanthamoeba cyst or trophozoites [146,147] whereas Rose Bengal mediated CXL did. [146].…”

Section: Photoactivated Chromophore CXL For Infectious Keratitis (Pac...mentioning

confidence: 98%

Corneal crosslinking in keratoconus management

Saad

Jouve

et al. 2020

Journal Français d'Ophtalmologie

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Section: Photoactivated Chromophore CXL For Infectious Keratitis (Pac...mentioning

confidence: 98%

Corneal crosslinking in keratoconus management

Saad

Jouve

et al. 2020

Journal Français d'Ophtalmologie

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“…High fluence PACK-CXL treatment may also target disease burden in AK, leading to pain relief, re-epithelization, and elimination of Acanthamoeba [118]. In another study, PACK-CXL halted corneal melting in the setting of AK [120]. While further investigation is needed, PACK-CXL may be a useful adjunctive therapy in recalcitrant AK.…”

Section: Photodynamic Therapy/cross-linkingmentioning

confidence: 99%

New Frontiers in Acanthamoeba Keratitis Diagnosis and Management

Shareef,

Saeed

2023

Biology

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Acanthamoeba Keratitis (AK) is a severe corneal infection caused by the Acanthamoeba species of protozoa, potentially leading to permanent vision loss. AK requires prompt diagnosis and treatment to mitigate vision impairment. Diagnosing AK is challenging due to overlapping symptoms with other corneal infections, and treatment is made complicated by the organism’s dual forms and increasing virulence, and delayed diagnosis. In this review, new approaches in AK diagnostics and treatment within the last 5 years are discussed. The English-language literature on PubMed was reviewed using the search terms “Acanthamoeba keratitis” and “diagnosis” or “treatment” and focused on studies published between 2018 and 2023. Two hundred sixty-five publications were initially identified, of which eighty-seven met inclusion and exclusion criteria. This review highlights the findings of these studies. Notably, advances in PCR-based diagnostics may be clinically implemented in the near future, while antibody-based and machine-learning approaches hold promise for the future. Single-drug topical therapy (0.08% PHMB) may improve drug access and efficacy, while oral medication (i.e., miltefosine) may offer a treatment option for patients with recalcitrant disease.

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“…The addition of autophagy inhibitors to multipurpose contact lens solution (MPS) reduced the adhesion rate of Acanthamoeba trophozoites to silicone hydrogel contact lenses compared with MPS with PHMB 46. There are case reports of adjunctive corneal crosslinking successfully improve or stabilize advanced AK 47–51…”

Section: Treatment Of Refractory Akmentioning

confidence: 99%

“…46 There are case reports of adjunctive corneal crosslinking successfully improve or stabilize advanced AK. [47][48][49][50][51] ' Clinical Example A 64-year-old physician was referred to the Massachusetts Eye and Ear emergency department for cornea consultation for 3 weeks of left eye pain and corneal ulceration. His past ocular history was significant for contact lens use in left eye only, for monovision.…”

Section: Treatment Of Refractory Akmentioning

confidence: 99%

An Update on the Initial Treatment of Acanthamoeba Keratitis

Wang¹,

Jacobs²

2022

International Ophthalmology Clinics

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Acanthamoeba keratitis (AK) is an infectious disease of the ocular surface that can be challenging to diagnose and treat and can lead to permanent loss of vision. It is most common in contact lens wearers, with reported rates of 1 to 33 cases per million contact lens wearers. 1,2 Acanthamoebae are protozoans ranging 25 to 50 um in size that can exist in either an active trophozoite or dormant cyst form. Several species of Acanthamoeba have been reported to cause AK, including A. castellanii and A. polyphaga. The cyst form can survive low temperatures and is resistant to biocides, chlorination, and antibiotics. 3 Patients can present with a variety of symptoms and signs that may be initially misdiagnosed as bacterial or viral keratitis. AK should be included in the differential diagnosis of any case presenting with unilateral keratitis, especially in the setting of contact lens wear, trauma, or contamination with soil or water. Patients typically present with pain, photophobia, and decreased visual acuity (VA). 4 Early findings include epitheliitis, with punctate keratopathy and pseudodendrites, often leading to a presumptive diagnosis of Herpes simplex keratitis. Patients may progress and develop perineural infiltrates, anterior stromal disease, deep stromal keratitis, or a ring infiltrate. 5 Although a ring infiltrate and perineural infiltrates are conventionally thought to be pathognomic for AK, they only occur in about 50% and 63% of cases, respectively, 4,6 and are findings that develop later in the disease course. Since the likelihood of medical cure is greater if diagnosis is made while the infection remains superficial, prompt recognition of the disease before the development of these later pathognomic signs is important. 5 Clinicians must consider risk factors, clinical course, and response to therapy in arriving at a preliminary

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Accelerated collagen cross-linking in the management of advanced Acanthamoeba keratitis

Cited by 11 publications

References 18 publications

Corneal crosslinking in keratoconus management

Corneal crosslinking in keratoconus management

New Frontiers in Acanthamoeba Keratitis Diagnosis and Management

An Update on the Initial Treatment of Acanthamoeba Keratitis

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