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Ryota Koh, Jane Y. Huang, Masahiko Kozawa, Eiichi Uchio; Treatment Outcome of Acanthamoeba Keratitis in Fukuoka University. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5834.
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Outbreaks of acanthamoeba keratitis (AK) have been increasing recently in Japan. The purpose of this study is to examine the treatment outcome of AK in Fukuoka University in recent 4 years.
We report on 15 eyes 15 cases of AK diagnosed and treated between 2007 and 2010 at Fukuoka University. All cases were diagnosed either based on positive microbial finding from corneal scrapings or contact lens (CL) cases, or by typical clinical manifestaions of AK. We evaluated the length of treatment, type of CL used, therapeutic success, and visual outcomes.
Fifteen eyes of 15 patients were diagnosed as AK. Seven out of 15 eyes (46.6%) were acanthamoeba positive from microbial culture of corneal scrapings or CL cases. Remaining 8 eyes (53.3%) were diagnosed based on typical findings of radialkeratitis. All cases were CL users with usage of soft CL (SCL) in 14 eyes and hard CL (HCL) in 1 eye. Among the SCL users, the frequent replacement type was used in 11 eyes (79%). Eight eyes (53%) were diagnosed for herpetic keratitis at previous clinic before referring to Fukuoka University. All cases underwent a protocol of topical 0.03% chlorhexidine gluconate and antimycotic drugs, regular corneal scraping, and 12 cases underwent additional treatment of systemic pentamidine isetionate. The average period of use of pentamidine isetionate were 8.5 days. Two cases required therapeutic keratoplasty (DALK). Average follow-up period was 6.1 months with improvement in visual acuity in 14 eyes. The average visual acuity improved from 0.1 (LogMAR 0.9) to 0.6 (LogMAR 0.2) at last follow-up date.
Early diagnosis and treatment of AK is critical for good visual prognosis. Systemic usage of pentamidine isetionate seem to be effective in AK.
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