Novel Effective Medical Therapy for Acanthamoeba Keratitis.

IF 2 4区医学 Q2 OPHTHALMOLOGY Eye & Contact Lens-Science and Clinical Practice Pub Date : 2024-06-01 Epub Date: 2024-05-01 DOI:10.1097/ICL.0000000000001092

Antonio Di Zazzo, Chiara De Gregorio, Marco Coassin

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Abstract

Purpose: To report first clinical use of novel medical treatment for Acanthamoeba keratitis.

Methods: 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.

Results: 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.

Conclusions: 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.

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治疗棘阿米巴角膜炎的新型有效药物疗法。

目的：报告新型医学疗法治疗阿卡阿米巴角膜炎的首次临床应用：干预性观察病例系列。两名阿卡阿米巴角膜炎患者曾接受 0.02% 波利海沙尼特（PHMB）和 0.1% 丙脒（propamidine）治疗 6 周，但均未获成功，随后所有患者均转为同情性使用 0.08% PHMB，并采用新的标准化方案。患者介入治疗后的随访时间至少为7个月：结果：PHMB 0.08%眼药水在新的标准化方案下改善了感染的解决，并使两个病例的病变在 4 周后完全愈合。角膜翳和新生血管缓慢减少，最佳矫正视力略有改善，并在随后的 7 个月中逐渐提高，感染未复发：这两例病例的初步报告表明，0.08% 波利沙尼有良好的疗效，可大幅缩短病程，降低复发几率，并主要改善患者的生活质量。

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来源期刊

Eye & Contact Lens-Science and Clinical Practice OPHTHALMOLOGY-

CiteScore

4.50

自引率

4.30%

发文量

150

审稿时长

6-12 weeks

期刊介绍： Eye & Contact Lens: Science and Clinical Practice is the official journal of the Contact Lens Association of Ophthalmologists (CLAO), an international educational association for anterior segment research and clinical practice of interest to ophthalmologists, optometrists, and other vision care providers and researchers. Focusing especially on contact lenses, it also covers dry eye disease, MGD, infections, toxicity of drops and contact lens care solutions, topography, cornea surgery and post-operative care, optics, refractive surgery and corneal stability (eg, UV cross-linking). Peer-reviewed and published six times annually, it is a highly respected scientific journal in its field.