UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Acanthamoeba keratitis therapy: time to cure and visual outcome analysis for different antiamoebic therapies in 227 cases

Dart, J; Papa, V; Rama, P; Radford, C; Minassian, D; (2019) Acanthamoeba keratitis therapy: time to cure and visual outcome analysis for different antiamoebic therapies in 227 cases. British Journal of Ophthalmology 10.1136/bjophthalmol-2019-314485. (In press). Green open access

[thumbnail of Dart_Acanthamoeba keratitis therapy. Time to cure and visual outcome analysis for different antiamoebic therapies in 227 cases_AAM.pdf]
Preview
Text
Dart_Acanthamoeba keratitis therapy. Time to cure and visual outcome analysis for different antiamoebic therapies in 227 cases_AAM.pdf - Accepted Version

Download (946kB) | Preview

Abstract

Abstract Aims To test the hypothesis that Acanthamoeba keratitis (AK) outcomes differ for different topical anti-amoebic therapies (AAT) and to provide detailed patient outcome data. Methods A retrospective cohort study of 227 patients developing AK between 25/07/1991-10/08/2012. Inclusion criteria required a complete record of AAT treatment for both the primary outcome of a medical cure rate at 12 months and the secondary outcome of Snellen VA 6/24 and/or surgical intervention. Analysis used multivariable regression to control for differences in baseline disease characteristics for both primary and secondary outcomes with unadjusted analyses for other outcomes. Subjects were categorised for analysis both by the AAT used at baseline and also by mutually exclusive AAT (patients exposed to all the drugs in each group, and no others, for some period). AAT categories were PHMB monotherapy, PHMB+diamidine, PHMB+chlorhexidine+diamidine, diamidine monotherapy and Other AAT. Results Analysis by baseline AAT showed no notable difference between treatments for both a medical cure at 12 months in 60.79% (138/227) or for a poor outcome in 49.34% (112/227). When AAT were analysed by mutually exclusive groups PHMB monotherapy provided the best outcomes. These findings are subject to bias requiring careful interpretation. Overall cure rates for the 214 subjects with resolved outcomes were 94.27% (214/227), median time to cure 5 months (interquartile range 3.25-9.00 months) and range 1-26.24 months. Conclusion PHMB 0.02% monotherapy for the initial treatment of AK is as effective as biguanide+diamidine combination therapy. Chlorhexidine monotherapy was too infrequent for comparison. The outcome data are the most detailed available.

Type: Article
Title: Acanthamoeba keratitis therapy: time to cure and visual outcome analysis for different antiamoebic therapies in 227 cases
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bjophthalmol-2019-314485
Publisher version: http://doi.org/10.1136/bjophthalmol-2019-314485
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Acanthamoeba keratitis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/10079362
Downloads since deposit
231Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item