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Acanthamoeba keratitis requires early diagnosis, aggressive treatment
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ATLANTIC CITY, N.J. — Treatment of Acanthamoeba keratitis hinges on prompt diagnosis and targeted therapy, according to a speaker here.
Stephen Kaufman, MD, PhD, discussed the diagnosis and treatment of Acanthamoeba keratitis at the Current Concepts in Ophthalmology meeting.
“The key to it … is to recognize that the earlier you can diagnose these and initiate treatment, the better the prognosis,” Kaufman said.
Currently, there are no U.S. Food and Drug Administration-approved treatments for Acanthamoeba keratitis, Kaufman said.
Kaufman said that herpes simplex virus may masquerade as Acanthamoeba. To ensure accurate diagnosis, he recommended a culture regimen using a chocolate agar with an E. coli overgrowth. The Acanthamoeba eats through the E. coli bacteria, leaving trails that are clearly visible with magnification.
Treatment options include PHMB 0.02% mixed with artificial tears. Patients should get a new bottle every 2 weeks because the agent loses potency in that time.
Other options include fluconazole, topical Brolene (propamidine isethionate), neomycin and Polysporin (bacitracin and polymyxin B ophthalmic, Johnson & Johnson). Steroids are not recommended, Kaufman said.
Patients should not wear their contact lenses when swimming, Kaufman said, citing the prevalence of Acanthamoeba keratitis among patients who swim in lakes in Minnesota.
Disclosure: Kaufman has no relevant financial disclosures.