ArticleJournal of optometry
Optimizing early diagnosis and treatment of acanthamoeba keratitis through corneal scraping.
Article in Journal of optometry. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Comments on: Optimizing early diagnosis and treatment of acanthamoeba keratitis through corneal scraping.Journal of optometry · 2026Article
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3 authors.
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Abstract
purposeAcanthamoeba keratitis (AK) is a sight-threatening disease, commonly associated with contact lens use. Early diagnosis is challenging due to its varied clinical presentation. This study aimed to describe the clinical characteristics of AK and evaluate the utility of corneal scraping for early diagnosis.
methodsThis retrospective study included 14 eyes from 13 AK patients diagnosed by detecting Acanthamoeba cysts in corneal scrapings between July 2019 and August 2023. Clinical history, presentation, treatment, and outcomes were analyzed.
resultsThe mean age of the 13 patients was 28 ± 13 years. Ten patients used soft contact lenses and 3 patients used orthokeratology lenses. The mean time from symptom onset to diagnosis was 18.2 ± 12.9 days. The most common sign was elevated superficial punctate keratitis (SPK), followed by dot infiltrates, radial perineuritis, pseudodendrites, stromal edema, and ring infiltrates. Nine eyes were treated with polyhexamethylene biguanide (PHMB) eye drops, while the remaining five eyes received a combination of two or three anti-amoebic agents. Thirteen eyes improved with treatment, but one eye-initially misdiagnosed and treated with steroids-required therapeutic keratoplasty. LogMAR visual acuity in eleven eyes improved from an initial 0.51 ± 0.44 to 0.11 ± 0.10 after treatment.
conclusionElevated SPK is the most frequent early feature of AK and may mimic contact lens-related sterile keratitis. Corneal scraping is a valuable diagnostic tool that enables earlier detection and improved outcomes. PHMB monotherapy is effective in early AK, while delayed diagnosis and prior steroid use may lead to disease progression and necessitate surgical intervention.
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