Chlorhexidine Monotherapy with Adjunctive Topical Corticosteroids for Acanthamoeba Keratitis

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Acanthamoeba keratitis (AK) is a serious eye infection that can lead to vision loss.
• Effective treatment strategies for AK are crucial for preserving visual acuity.

Purpose of the Study:

• To evaluate the efficacy of chlorhexidine as a standalone treatment for Acanthamoeba keratitis.
• To assess the outcomes of using topical corticosteroids alongside chlorhexidine therapy.

Main Methods:

• A prospective case series involving 31 patients diagnosed with AK.
• Treatment involved chlorhexidine 0.02% monotherapy, with diagnosis confirmed by confocal microscopy.
• Outcomes measured included clinical response, visual acuity, treatment duration, and need for further interventions like penetrating keratoplasty.

Main Results:

• 83.9% of patients showed clinical improvement within two weeks of chlorhexidine treatment.
• 26 patients (83.9%) received adjunctive topical corticosteroids.
• Final visual acuity was ≥0.80 in 71% of eyes, with 93.5% experiencing improved vision.

Conclusions:

• Chlorhexidine monotherapy is an effective initial treatment for Acanthamoeba keratitis.
• Topical corticosteroids can be safely used as adjunctive therapy after initial response to anti-Acanthamoeba agents.