Document Detail


Visual outcome in Japanese patients with Acanthamoeba keratitis.
MedLine Citation:
PMID:  22241017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To identify prognostic factors affecting visual outcome in Acanthamoeba keratitis (AK) treated with topical chlorhexidine gluconate (CHG).
METHODS: A total of 35 eyes in 34 patients with AK were treated with 0.02% topical CHG. Patients were divided into two groups according to the final visual outcome: Group 1, final visual acuity (VA) of 20/25 or greater (22 eyes); Group 2, less than 20/25 (13 eyes). We compared these groups and evaluated the effectiveness of topical CHG compared with outcomes in previous reports.
RESULTS: Ring infiltrate was observed more often in Group 2 (4.5% vs 61.5%, OR 33.6, 95% confidence interval (CI) 3.4-333.9, P<0.01). The duration between onset and diagnosis of AK was significantly longer (24.9 days vs 48.4 days, OR 1.03, 95% CI 1.00-1.06, P = 0.04) and VA at initial examination (log MAR) significantly lower (0.47 vs 1.59, OR 25.5, 95% CI 3.4-186.7, P<0.01) in Group 2 (visual outcome <20/25). Multivariate analysis revealed that only VA at initial examination was independently associated with worse visual outcome (adjusted OR 24.5, 95% CI 1.9-312.6, P=0.01). Seventeen (85.0%) of the 20 eyes diagnosed within 1 month and 24 (82.8%) of 29 eyes diagnosed within 2 months achieved a VA of 20/40 or greater.
CONCLUSION: VA at initial examination was the most predictive factors for final visual outcome in AK. Topical CHG was comparably effective to other treatments, including polyhexamethyl biguanide and propamidine isethionate.
Authors:
K Yamazoe; Y Yamamoto; S Shimazaki-Den; J Shimazaki
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Publication Detail:
Type:  Journal Article     Date:  2012-01-13
Journal Detail:
Title:  Eye (London, England)     Volume:  26     ISSN:  1476-5454     ISO Abbreviation:  Eye (Lond)     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-12     Completed Date:  2012-06-05     Revised Date:  2013-04-01    
Medline Journal Info:
Nlm Unique ID:  8703986     Medline TA:  Eye (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  517-22     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, Tokyo Dental College, Chiba, Japan. kyamazoe1528@yahoo.co.jp
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MeSH Terms
Descriptor/Qualifier:
Acanthamoeba Keratitis / drug therapy*,  physiopathology
Adolescent
Adult
Anti-Infective Agents, Local / therapeutic use*
Chlorhexidine / analogs & derivatives*,  therapeutic use
Female
Humans
Japan
Male
Middle Aged
Prognosis
Treatment Outcome
Visual Acuity / drug effects*,  physiology
Young Adult
Chemical
Reg. No./Substance:
0/Anti-Infective Agents, Local; 18472-51-0/chlorhexidine gluconate; 55-56-1/Chlorhexidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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