Practice patterns and opinions in the treatment of acanthamoeba keratitis

Catherine E. Oldenburg, Nisha R. Acharya, Elmer Y. Tu, Michael E. Zegans, Mark J Mannis, Bruce D. Gaynor, John P. Whitcher, Thomas M. Lietman, Jeremy D. Keenan

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

PURPOSE:: Management of acanthamoeba keratitis remains challenging for ophthalmologists. We conducted a survey of members of The Cornea Society to elicit expert opinions on the diagnosis and treatment of acanthamoeba keratitis. METHODS:: An online survey was sent to all subscribers of The Cornea Society via the kera-net listserv. Descriptive statistics were performed. RESULTS:: Eighty-two participants completed the online survey. Of the 82 respondents, 76.8% included the combination of clinical examination and culture in their diagnostic strategy and 43.9% used confocal microscopy. Most respondents (97.6%) had used combination therapy with multiple agents to treat acanthamoeba keratitis at some point in the past, whereas a smaller proportion (47.6%) had ever used monotherapy. Respondents most commonly chose polyhexamethylene biguanide as the ideal choice for monotherapy (51.4%), and dual therapy with a biguanide and diamidine as the ideal choice for combination therapy (37.5%). The majority of respondents (62.2%) reported using topical corticosteroids at least some of the time for acanthamoeba keratitis. Keratoplasty was an option considered by most respondents (75.6%), although most (85.5%) would only perform surgery after medical treatment failure. CONCLUSIONS:: There was a wide range of current practice patterns for the diagnosis and treatment of acanthamoeba keratitis. The lack of sufficiently powered comparative effectiveness studies and clinical trials makes evidence-based decision-making for this disease difficult.

Original languageEnglish (US)
Pages (from-to)1363-1368
Number of pages6
JournalCornea
Volume30
Issue number12
DOIs
StatePublished - Dec 2011

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Keywords

  • Bayesian
  • combination therapy
  • corticosteroids
  • keratoplasty
  • monotherapy

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Oldenburg, C. E., Acharya, N. R., Tu, E. Y., Zegans, M. E., Mannis, M. J., Gaynor, B. D., Whitcher, J. P., Lietman, T. M., & Keenan, J. D. (2011). Practice patterns and opinions in the treatment of acanthamoeba keratitis. Cornea, 30(12), 1363-1368. https://doi.org/10.1097/ICO.0b013e31820f7763