Abstract
Purpose :
Acanthamoeba keratitis (AK) is a sight-threatening corneal infection that can potentially lead to blindness. Conventional drugs aim to eradicate trophozoites and cysts from the cornea. However, in many cases, the associated severe inflammation can worsen the corneal damage, result in corneal scarring, and delay the healing process. Herein, we aim to evaluate the outcome of using topical 2% cyclosporine to limit the corneal inflammation in AK patients.
Methods :
Retrospective case-series of patients with AK and severe corneal inflammation assessed by in vivo confocal microscopy (IVCM) that received topical 2% cyclosporine four times daily in addition to their standard amoebicidal therapy.
Results :
Six patients (three males and three females), with a mean age of 34.6±7.8 years, were included. The mean follow-up duration was 4.3±0.2 months (range 6-2). After treatment, BCVA increased from 1.02±0.3 to 0.4±0.2 logMAR (p<0.05), 3 patients had complete epithelial healing, and 3 showed reduced corneal staining. Further, 2 patients had an improvement in corneal haze that correlated with an improvement in BCVA (from 0.6 to 0.2 and from 1.6 to 1.1 logMAR, respectively). Finally, corneal inflammatory cell density as assessed by IVCM significantly decreased from 471.8±61 to 93.75±17.23 cells/mm2.
Conclusions :
In patients with Acanthamoeba keratitis, the use of topical 2% cyclosporine four times daily as adjunct therapy can aid limiting the burden of corneal inflammation, promoting the epithelial healing, and potentially improve the treatment outcome. Further randomized controlled studies are needed to confirm our preliminary results.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.