Diagnostic Considerations for Non-<i>Acanthamoeba</i> Amoebic Keratitis and Clinical Outcomes
Cases of amoebic keratitis involving species other than <i>Acanthamoeba</i> are hypothesised to be underdiagnosed and poorly understood. Amoebic keratitis is debilitating and associated with chronic visual impairment. Understanding associated symptoms of non-<i>Acanthamoeba</i&g...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Pathogens |
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| Online Access: | https://www.mdpi.com/2076-0817/11/2/219 |
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| author | Siobhan Moran Ronnie Mooney Fiona L. Henriquez |
| author_facet | Siobhan Moran Ronnie Mooney Fiona L. Henriquez |
| author_sort | Siobhan Moran |
| collection | DOAJ |
| description | Cases of amoebic keratitis involving species other than <i>Acanthamoeba</i> are hypothesised to be underdiagnosed and poorly understood. Amoebic keratitis is debilitating and associated with chronic visual impairment. Understanding associated symptoms of non-<i>Acanthamoeba</i> amoebic keratitis could facilitate new diagnostic procedures and enable prompt treatment, ultimately leading to improved patient outcomes. Thus, a review of the literature was undertaken surrounding non-<i>Acanthamoeba</i> amoebic keratitis. Cases were geographically widespread and mostly confined to contact lens wearers ≤ 30 years old exposed to contaminated water sources and/or demonstrating poor lens hygiene. <i>Vermamoeba vermiformis</i> (previously <i>Hartmanella vermiformis</i>) was the most common causative agent, and a moderate number of mixed keratitis cases were also reported. A crucial disease indicator was early onset stromal deterioration/ulcerations, reported in 10 of the studies, usually only occurring in advanced <i>Acanthamoeba</i> keratitis. Mixed infections were the most difficult to treat, often requiring keratoplasty after unsuccessful combination treatment regimens. New diagnostic measures for non-<i>Acanthamoeba</i> amoebic keratitis should consider early onset stromal disease as a key disease indicator. Deep corneal scrapes are also necessary for accurate amoebic identification. Moreover, a combination approach to diagnosis is advised and should involve culture, microscopy and PCR techniques. In vitro drug sensitivity tests should also be conducted to help develop patient-specific treatment regimes. |
| first_indexed | 2024-03-09T21:16:46Z |
| format | Article |
| id | doaj.art-3b78b01dbcea4f5b887da105bfad7373 |
| institution | Directory Open Access Journal |
| issn | 2076-0817 |
| language | English |
| last_indexed | 2024-03-09T21:16:46Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pathogens |
| spelling | doaj.art-3b78b01dbcea4f5b887da105bfad73732023-11-23T21:32:15ZengMDPI AGPathogens2076-08172022-02-0111221910.3390/pathogens11020219Diagnostic Considerations for Non-<i>Acanthamoeba</i> Amoebic Keratitis and Clinical OutcomesSiobhan Moran0Ronnie Mooney1Fiona L. Henriquez2School of Health and Life Sciences, University of West Scotland, Stephenson Place, Glasgow G72 0LH, Lanarkshire, UKSchool of Health and Life Sciences, University of West Scotland, Stephenson Place, Glasgow G72 0LH, Lanarkshire, UKSchool of Health and Life Sciences, University of West Scotland, Stephenson Place, Glasgow G72 0LH, Lanarkshire, UKCases of amoebic keratitis involving species other than <i>Acanthamoeba</i> are hypothesised to be underdiagnosed and poorly understood. Amoebic keratitis is debilitating and associated with chronic visual impairment. Understanding associated symptoms of non-<i>Acanthamoeba</i> amoebic keratitis could facilitate new diagnostic procedures and enable prompt treatment, ultimately leading to improved patient outcomes. Thus, a review of the literature was undertaken surrounding non-<i>Acanthamoeba</i> amoebic keratitis. Cases were geographically widespread and mostly confined to contact lens wearers ≤ 30 years old exposed to contaminated water sources and/or demonstrating poor lens hygiene. <i>Vermamoeba vermiformis</i> (previously <i>Hartmanella vermiformis</i>) was the most common causative agent, and a moderate number of mixed keratitis cases were also reported. A crucial disease indicator was early onset stromal deterioration/ulcerations, reported in 10 of the studies, usually only occurring in advanced <i>Acanthamoeba</i> keratitis. Mixed infections were the most difficult to treat, often requiring keratoplasty after unsuccessful combination treatment regimens. New diagnostic measures for non-<i>Acanthamoeba</i> amoebic keratitis should consider early onset stromal disease as a key disease indicator. Deep corneal scrapes are also necessary for accurate amoebic identification. Moreover, a combination approach to diagnosis is advised and should involve culture, microscopy and PCR techniques. In vitro drug sensitivity tests should also be conducted to help develop patient-specific treatment regimes.https://www.mdpi.com/2076-0817/11/2/219keratitisamoebahartmannellaacanthamoebavannellavahlkampfia |
| spellingShingle | Siobhan Moran Ronnie Mooney Fiona L. Henriquez Diagnostic Considerations for Non-<i>Acanthamoeba</i> Amoebic Keratitis and Clinical Outcomes Pathogens keratitis amoeba hartmannella acanthamoeba vannella vahlkampfia |
| title | Diagnostic Considerations for Non-<i>Acanthamoeba</i> Amoebic Keratitis and Clinical Outcomes |
| title_full | Diagnostic Considerations for Non-<i>Acanthamoeba</i> Amoebic Keratitis and Clinical Outcomes |
| title_fullStr | Diagnostic Considerations for Non-<i>Acanthamoeba</i> Amoebic Keratitis and Clinical Outcomes |
| title_full_unstemmed | Diagnostic Considerations for Non-<i>Acanthamoeba</i> Amoebic Keratitis and Clinical Outcomes |
| title_short | Diagnostic Considerations for Non-<i>Acanthamoeba</i> Amoebic Keratitis and Clinical Outcomes |
| title_sort | diagnostic considerations for non i acanthamoeba i amoebic keratitis and clinical outcomes |
| topic | keratitis amoeba hartmannella acanthamoeba vannella vahlkampfia |
| url | https://www.mdpi.com/2076-0817/11/2/219 |
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