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Antonino Asero, Christina Olsen, Ritchie Head, Vincenzo Papa; Current Practice in the Treatment of Acanthamoeba Keratitis used by International Cornea Specialists: Preliminary Survey results obtained by ODAK Team. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2668.
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© ARVO (1962-2015); The Authors (2016-present)
Acanthamoeba keratitis (AK) is a rare infectious disease, predominantly affecting healthy young contact lens users provoking severe morbidity due to pain and photophobia. AK, in the absence of treatment, progresses to blindness as result of corneal perforation. Despite this severe condition, there are no drugs approved treating this devastating disease. The most used off-label therapy is a combination of Polyhexamethylene biguanide (PHMB) with a diamidine (Propamidine or Hexamidine), but many other options are utilized by ophthalmologists in the world. This survey follows a retrospective study conduct from us in two leading EU centers where most AK patients were treated with PHMB (Papa et al ARVO 2014). The purpose of this survey is to better assess practice patterns in the treatment of AK in different Countries
Seventy cornea specialists at EuCornea 2017 was requested to fill out a questionnaire in which their experience in the management of the AK was surveyed. All the range of off-label treatments used, the number of AK patients visited per year together with misdiagnosis estimation of AK was also documented.
Eighty-four percent of our survey respondents had examined AK patients in the last nine months. The majority of them (32%) see 2-5 patients per year. In some European geographical area (e.g. UK) recruitment of AK patients can be ranged between 5-10. Most of respondents (31%) preferred to treat patients with chlorhexidine whereas 25% choose PHMB. Propamidine (21%) or Hexamidine (6%) were the most common drugs associated with PHMB or chlorhexidine. Others (9%) selected Voriconazole. Most of respondents (>50%) confirmed misdiagnosis of 50% patients with herpes simplex keratitis. Only 50% of respondents send patients to a specialized center for proper disease management
Cornea specialists adopt different approach in treating AK. Most of them use off-label products because no licensed drugs are available. Moreover not always is possible to manage and diagnose correctly the disease for the absence of specific guidelines. The current survey reinforce the aim of the ODAK team in sustaining the progress of clinical Phase III study with an effective and safe PHMB 0.08% as monotherapy to treat AK patients through an accurate clinical management protocol.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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