scholarly journals Current Trends in Treating Acanthamoeba Keratitis: A Brief Narrative Review

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Mauro Salducci
Keyword(s):  
Contact Lenses ◽  
Tap Water ◽  
Acanthamoeba Keratitis ◽  
Response To Treatment ◽  
Contaminated Water ◽  
Drug Induced ◽  
Current Trends ◽  
Corneal Lens ◽  
Acanthamoebic Keratitis ◽  
Bacteria And Fungi

The Author, after examining the historical evolution of scientific knowledge and treatment of severe Acanthamoebic keratitis, presents this brief review on the treatment of this serious eye disease, relatively frequent in patients with corneal contact lenses. Therapy of Acanthamoeba keratitis is always very long and demanding. Its management requires adequate experience because it is not always easy to evaluate the response to treatment and complications can be very serious and difficult to manage. Resistance to therapy can also occur during treatment and must be distinguished from drug-induced toxicity. In cases where no improvement is obtained with maximum medical therapy, it is advisable to repeat the corneal sampling and proceed to new laboratory tests for Acanthamoeba, bacteria and fungi. Prevention, which always remains of fundamental importance, is practically based on avoiding contact of the corneal lens with contaminated water, since this Acanthamoeba has a ubiquitous diffusion. It is therefore recommended to always avoid the use of corneal contact lenses in the pool or in the shower, not to wash them under running tap water and to frequently replace the relative container of these lenses. Key Words:  Acanthamoeba Keratitis, Corneal ulcer, Contact lenses.

scholarly journals Acanthamoeba keratitis related to contact lens in a tertiary hospital in China

2019 ◽  
Author(s):  
Weiwei Li ◽  
Zhiqun Wang ◽  
Jinghao Qu ◽  
Yang Zhang ◽  
Xuguang Sun
Keyword(s):  
Confocal Microscopy ◽  
Contact Lens ◽  
Contact Lenses ◽  
Early Stage ◽  
Tap Water ◽  
Acanthamoeba Keratitis ◽  
Tertiary Hospital ◽  
Chi Square ◽  
Soft Contact Lenses ◽  
Chi Square Test

Abstract Backgroud To report the clinical and microbiological features of Acanthamoeba keratitis (AK) related to contact lens in a tertiary hospital in China. Methods In this retrospective study, medical results of 61 cases of AK related to contact lens were reviewed from January 2000 to December 2017. The data included patients’ demographics, lens type, history, risk factors, the disease stages, reports of corneal scrapings and culture, treatment. Moreover, the genotype identification of part of these isolates was carried out with a PCR assay and sequence analysis of the 18S ribosomal DNA gene. Results There were 64 eyes included in the study. And 32.8% of cases wore soft contact lenses, 67.2% of patients used overnight orthokeratology. In the cases (20eyes) of early stage, 65% (13 eyes) had positive results in Giemsa stained smears, trophozoites were seen in 7 eyes (35%) in 0.9% sodium chloride (NaCl) wet mounts. Six eyes (30%) were diagnosed by confocal microscopy together with clinical sign. In the orthokeratology patients, 87.8% (36/41) of cases rinsed the lenses and/or cases with tap water, while 55% of soft lens wearers wore their lens during showering. The genotype of 9 isolates was determined, all the strains belonged to genotype T4. In the orthokeratology related cases, patients required therapeutic penetrating keratoplasty after 2005 were less than before 2005 (Chi-square test, χ2= 4.209，P = 0.04). Conclusions More than two thirds of cases were associated with orthokeratology. The examinations of Giemsa stained smears, 0.9% NaCl wet mounts and confocal microscopy should be done for the highly suspected cases of early stage to help the early diagnosis. The rate of therapeutic keratoplasty was decrease after 2005 compare with before 2005 in the cases of orthokeratology.

scholarly journals Acanthamoeba keratitis related to contact lens use in a tertiary hospital in China

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Weiwei Li ◽  
Zhiqun Wang ◽  
Jinghao Qu ◽  
Yang Zhang ◽  
Xuguang Sun
Keyword(s):  
Confocal Microscopy ◽  
Contact Lens ◽  
Contact Lenses ◽  
Early Stage ◽  
Tap Water ◽  
Clinical Signs ◽  
Acanthamoeba Keratitis ◽  
Tertiary Hospital ◽  
Soft Contact Lenses ◽  
Number Of Patients

Abstract Background To report the clinical and microbiological features of Acanthamoeba keratitis (AK) related to contact lens use in a tertiary hospital in China. Methods In this retrospective study, the medical results of 61 cases of AK related to contact lens use from January 2000 to December 2017 were reviewed. The data included patients’ demographics, lens type, history, risk factors, disease stages, corneal scraping and culture reports, and treatments. Moreover, genotypic identification of some of the isolates was carried out with a PCR assay and sequence analysis of the 18S ribosomal DNA gene. Results There were 64 eyes included in the study. A total of 32.8% of the patients wore soft contact lenses, and 67.2% of patients used overnight orthokeratology. In the cases (20 eyes) in the early stage, 65% (13 eyes) had positive results according to Giemsa-stained smears, and 0.9% sodium chloride (NaCl) wet mounts revealed trophozoites in 7 eyes (35%). Six eyes (30%) were diagnosed by confocal microscopy combined with clinical signs. In the orthokeratology patients, 87.8% (36/41) rinsed their lenses and/or cases with tap water; 55% of soft-lens wearers wore their lenses while showering. The genotype of 9 isolates was determined, and all the strains belonged to genotype T4. In the orthokeratology group, the number of patients who required therapeutic penetrating keratoplasty after 2005 was less than that before 2005 (chi-square test, χ2 = 4.209, P = 0.04). Conclusions More than two-thirds of the cases were associated with orthokeratology. Examinations with Giemsa-stained smears, 0.9% NaCl wet mounts and confocal microscopy should be performed for patients who are highly suspected of having early-stage AK to help with early diagnosis. In the orthokeratology group, the rate of therapeutic keratoplasty after 2005 was less than that before 2005.

scholarly journals Acanthamoeba keratitis related to contact lens use in a tertiary hospital in China

2019 ◽  
Author(s):  
Weiwei Li ◽  
Zhiqun Wang ◽  
Jinghao Qu ◽  
Yang Zhang ◽  
Xuguang Sun
Keyword(s):  
Confocal Microscopy ◽  
Contact Lens ◽  
Contact Lenses ◽  
Early Stage ◽  
Tap Water ◽  
Clinical Signs ◽  
Acanthamoeba Keratitis ◽  
Tertiary Hospital ◽  
Soft Contact Lenses ◽  
Number Of Patients

Abstract Background: To report the clinical and microbiological features of Acanthamoeba keratitis (AK) related to contact lens use in a tertiary hospital in China. Methods: In this retrospective study, the medical results of 61 cases of AK related to contact lens use from January 2000 to December 2017 were reviewed. The data included patients’ demographics, lens type, history, risk factors, disease stages, corneal scraping and culture reports, and treatments. Moreover, genotypic identification of some of the isolates was carried out with a PCR assay and sequence analysis of the 18S ribosomal DNA gene. Results: There were 64 eyes included in the study. A total of 32.8% of the patients wore soft contact lenses, and 67.2% of patients used overnight orthokeratology. In the cases (20 eyes) in the early stage, 65% (13 eyes) had positive results according to Giemsa-stained smears, and 0.9% sodium chloride (NaCl) wet mounts revealed trophozoites in 7 eyes (35%). Six eyes (30%) were diagnosed by confocal microscopy combined with clinical signs. In the orthokeratology patients, 87.8% (36/41) rinsed their lenses and/or cases with tap water; 55% of soft-lens wearers wore their lenses while showering. The genotype of 9 isolates was determined, and all the strains belonged to genotype T4. In the orthokeratology group, the number of patients who required therapeutic penetrating keratoplasty after 2005 was less than that before 2005 (chi-square test, χ 2 = 4.209, P = 0.04). Conclusions: More than two-thirds of the cases were associated with orthokeratology. Examinations with Giemsa-stained smears, 0.9% NaCl wet mounts and confocal microscopy should be performed for patients who are highly suspected of having early-stage AK to help with early diagnosis. In the orthokeratology group, the rate of therapeutic keratoplasty after 2005 was less than that before 2005.

scholarly journals Acanthamoeba keratitis related to contact lens use in a tertiary hospital in China

2019 ◽  
Author(s):  
Weiwei Li ◽  
Zhiqun Wang ◽  
Jinghao Qu ◽  
Yang Zhang ◽  
Xuguang Sun
Keyword(s):  
Confocal Microscopy ◽  
Contact Lens ◽  
Contact Lenses ◽  
Early Stage ◽  
Tap Water ◽  
Clinical Signs ◽  
Acanthamoeba Keratitis ◽  
Tertiary Hospital ◽  
Soft Contact Lenses ◽  
Number Of Patients

Abstract Background: To report the clinical and microbiological features of Acanthamoeba keratitis (AK) related to contact lens use in a tertiary hospital in China. Methods: In this retrospective study, the medical results of 61 cases of AK related to contact lens use from January 2000 to December 2017 were reviewed. The data included patients’ demographics, lens type, history, risk factors, disease stages, corneal scraping and culture reports, and treatments. Moreover, genotypic identification of some of the isolates was carried out with a PCR assay and sequence analysis of the 18S ribosomal DNA gene. Results: There were 64 eyes included in the study. A total of 32.8% of the patients wore soft contact lenses, and 67.2% of patients used overnight orthokeratology. In the cases (20 eyes) in the early stage, 65% (13 eyes) had positive results according to Giemsa-stained smears, and 0.9% sodium chloride (NaCl) wet mounts revealed trophozoites in 7 eyes (35%). Six eyes (30%) were diagnosed by confocal microscopy combined with clinical signs. In the orthokeratology patients, 87.8% (36/41) rinsed their lenses and/or cases with tap water; 55% of soft-lens wearers wore their lenses while showering. The genotype of 9 isolates was determined, and all the strains belonged to genotype T4. In the orthokeratology group, the number of patients who required therapeutic penetrating keratoplasty after 2005 was less than that before 2005 (chi-square test, χ 2 = 4.209, P = 0.04). Conclusions: More than two-thirds of the cases were associated with orthokeratology. Examinations with Giemsa-stained smears, 0.9% NaCl wet mounts and confocal microscopy should be performed for patients who are highly suspected of having early-stage AK to help with early diagnosis. In the orthokeratology group, the rate of therapeutic keratoplasty after 2005 was less than that before 2005.

scholarly journals Continuous Real-Time Motility Analysis of Acanthamoeba Reveals Sustained Movement in Absence of Nutrients

Pathogens ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 995
Author(s):  
Allison Campolo ◽  
Valerie Harris ◽  
Rhonda Walters ◽  
Elise Miller ◽  
Brian Patterson ◽  
...  
Keyword(s):  
Contact Lens ◽  
Contact Lenses ◽  
Axenic Culture ◽  
Acanthamoeba Keratitis ◽  
Ocular Infection ◽  
Glass Coverslip ◽  
E Coli ◽  
Total Distance ◽  
Care Systems ◽  
Different Strains

Acanthamoeba keratitis is a serious ocular infection which is challenging to treat and can lead to blindness. While this pathogen is ubiquitous and can contaminate contact lenses after contact with water, its habits remain elusive. Understanding this organism’s natural behavior will better inform us on how Acanthamoeba colonize contact lens care systems. Acanthamoeba trophozoites were allowed to adhere to either a glass coverslip or non-nutrient agar (NNA) within a flow cell with nutrients (Escherichia coli or an axenic culture medium (AC6)) or without nutrients (Ringer’s solution). Images were taken once every 24 s over 12 h and compiled, and videos were analyzed using ImageJ Trackmate software. Acanthamoeba maintained continuous movement for the entire 12 h period. ATCC 50370 had limited differences between conditions and surfaces throughout the experiment. Nutrient differences had a noticeable impact for ATCC 30461, where E. coli resulted in the highest total distance and speed during the early periods of the experiment but had the lowest total distance and speed by 12 h. The Ringer’s and AC6 conditions were the most similar between strains, while Acanthamoeba in the E. coli and NNA conditions demonstrated significant differences between strains (p < 0.05). These results indicate that quantifiable visual tracking of Acanthamoeba may be a novel and robust method for identifying the movement of Acanthamoeba in relation to contact lens care products. The present study indicates that Acanthamoeba can undertake sustained movement for at least 12 h with and without nutrients, on both rough and smooth surfaces, and that different strains have divergent behavior.

Optimum | Tangible Hydra-PEG™ – Gaining Momentum in the Industry

The Eye ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 31-34
Author(s):  
M. Conway
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Surface Coating ◽  
Clinical Case ◽  
Contact Lenses ◽  
Ocular Surface Disease ◽  
Corneal Ectasia ◽  
Corneal Lens ◽  
Eye Symptoms ◽  
Dry Eye Symptoms

The issue of hydrophilicity of the surface of gas permeable contact lenses remains one of the persistent problems. Tangible Hydra-PEG™ surface coating is applied to gas permeable contact lenses to significantly improve wettability and wearing comfort. Although it is mainly used to alleviate dry eye symptoms in scleral and corneal lens users, particularly for those patients with corneal ectasia and/or Ocular Surface Disease (OSD), it can be used in other modalities. This article describes the development of the product and describes the benefits of its use in a clinical case.

Awareness of Contact Lens Related Ocular Complications among Opticians of Lahore

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Ahmed Sohail ◽  
Zain Ul Abideen ◽  
Fatima Zahid ◽  
Wahid Bakhsh
Keyword(s):  
Contact Lens ◽  
Contact Lenses ◽  
Corneal Opacity ◽  
Acanthamoeba Keratitis ◽  
Bacterial Keratitis ◽  
Age Group ◽  
Cross Sectional Survey ◽  
Ocular Complications ◽  
Cross Sectional ◽  
One Year

Purpose:  To determine the awareness regarding contact lens related ocular complications among opticians of Lahore and to find out the relationship between the awareness and their educational qualification. Study Design:  Cross sectional survey. Place and duration of Study: University of Lahore from April 2020- December 2020. Methods:  This survey included opticians of different areas of Lahore, Pakistan. Two hundred and eleven opticians responded to a pre-tested, structured close ended questionnaire. Data comprised of demographics and contact lens selling experience. Information regarding awareness about contact lens related complications was also sought. The data were analyzed using SPSS 25.0. Results:  A total of 211 opticians participated in the survey. All subjects were males. Fifty four (25.6%) subjects were from the age group of 15 to 30 years, 122 (57.8%) were from the age group of 31 to 45 and 35 (16.6%) were from the age group of 46 to 60 years. Only 4.7% had contact lens dispensing diploma. Thirty seven percent patients had contact lens selling experience of 2 to 10 years. Similar percentage had more than 10 years of experience. Ten percent had less than one year of experience. Only 54 participants out of 211 had knowledge about dry eye, 9 knew about Acanthamoeba keratitis and Bacterial keratitis and only 2 were aware of corneal opacity. Conclusion:  Majority of the opticians of Lahore are unaware of the contact lenses related complications. Sale of cosmetic lenses for fashion purpose should be discouraged and banned if not prescribed by optometrist/ ophthalmologist. Key Words:  Opticians, Contact lenses, Bacterial Keratitis.

Disorders of Pigmentation

2012 ◽  
Author(s):  
Pearl E. Grimes
Keyword(s):  
Differential Diagnosis ◽  
Narrow Band ◽  
Skin Pigmentation ◽  
Ultraviolet B ◽  
Response To Treatment ◽  
Therapeutic Approaches ◽  
Drug Induced ◽  
Degos Disease ◽  
Postinflammatory Hyperpigmentation ◽  
Disease And Disorders

The disorders of skin pigmentation discussed in this chapter fall into two categories: disorders of hyperpigmentation (melasma, postinflammatory hyperpigmentation, drug-induced hyperpigmentation, erythema dyschromicum perstans, lentigines, confluent and reticulated papillomatosis of Gougerot and Carteaud, and Dowling-Degos disease) and disorders of hypopigmentation (vitiligo, albinism, piebaldism, and idiopathic guttate hypomelanosis). The definition, epidemiology, etiology and pathogenesis, diagnosis, differential diagnosis, and treatment are discussed for each condition. Figures show examples of melasma, hyperpigmentation secondary to acne, vitiligo and its response to treatment with tacrolimus and with narrow-band ultraviolet B (UVB) light, Vogt-Koyanagi-Harada syndrome, and piebaldism. A table lists therapeutic approaches to vitiligo. This chapter contains 182 references.

Does Nutritional Status Affect Treatment Tolarability, Response and Survival in Metastatic Colorectal Cancer Patients? Results of a Prospective Multicenter Study

2020 ◽  
Author(s):  
Karabulut Senem ◽  
Dogan Izzet ◽  
Cigdem Usul Afsar ◽  
Karabulut Mehmet ◽  
Sule Kahraman ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Nutritional Status ◽  
Metastatic Colorectal Cancer ◽  
Multicenter Study ◽  
Cytotoxic Chemotherapy ◽  
Response To Treatment ◽  
Severe Malnutrition ◽  
Chemotherapy Response ◽  
Drug Induced

Abstract Background: The efficacy and tolerability of modern cytotoxic chemotherapy regimens used in malnourished metastatic colorectal cancer (mCRC) patients is uncertain. The aim of this study was to investigate the effect of malnutrition on efficacy and tolerability of cytotoxic chemotherapy and overall survival in mCRC patients.Methods: In this multicenter study, demographic, oncologic and nutritional data were collected prospectively from mCRC patients. Nutritional status of the patients were evaluated on the basis of NRI, BMI and WL before the first chemotherapy, after the first and second chemotherapy during 2 cycles of chemotherapy every 15 days. To determine the inter-treatment weight loss toxicity assessment was included to theese parameters after each chemotherapy. NRI calculation was performed as [1.51xserum albumin level (g/L)+41.7xcurrent weight/basic weight]. . NRIs were examined in 3 categories as ‘no malnutrition’ (NRI >97.5), ‘moderate malnutrition’ (97.5 ≥ NRI ≥83.5) or ‘severe malnutrition’ (NRI <83.5). Response to treatment and drug-induced toxicities were assessed based on Criteria in Solid Tumors (RECIST) 1.1 and National Cancer Institute CTCAE version 4.0 respectively.Results: One-hundred and thirty-seven mCRC patients were prospectively included. Median age was 48 (range 18-83). Primary location was colon in 66% of patients and 84% of their primary source was left colon. Malnutrition was detected in 39% of the cases. Response rate to treatment was twenty four percent. While there was no significant relationship between chemotherapy response and moderate/severe malnutrition (p=0.24), moderate/severe malnutrition was associated with multipl site of metastases, WHO PS of 1, over the median value of CEA/CA 19-9 levels (p=0.003, p=0.03, p<0.001, and p=0.02; respectively). Hypoalbuminemia and moderate/severe malnutrition were associated with all types of toxicity (p<0.001 and p<0.001). Moderate/severe malnutrition was associated with thrombocytopenia, and diarrhea following chemotherapy predominately, (p=0.02 and p=0.04; respectively). In moderate/severe malnutrition group median overall survival was prominently shorter than those with no malnutrition [6.6 moths (95%CI, 5.6-7.6) vs 11.9 moths (95% CI, 11.1-12.7) respectively, p<0.001].Conclusions: Our study showed that moderate/severe malnutrition in mCRC patients was associated with decreased overall survival and increased chemotherapy toxicity.

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