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:: Volume 26, Issue 1 (Iranian Journal of Ophthalmology 2014) ::
2014, 26(1): 41-47 Back to browse issues page
Clinical Outcomes in Acanthamoeba Keratitis Treated with Polyhexamethylene Biguanide as Monotherapy
Firoozeh Rahimi Dr., Seyed Mohsen Rafizadeh Dr. * , Amir Houshang Beheshtnejad Dr., Mohammad Nasser Hashemian Dr., Mohammad Ali Zare Dr., Sedigheh Kohansal Dr., Abdolreza Shakib Dr., Ali Kord Valeshabad
, mohsen_raf1354@yahoo.com
Abstract:   (8438 Views)

 Purpose: To assess the efficacy of polyhexamethylene biguanide (PHMB) in treating Acanthamoeba keratitis (AK) and also to identify related factors affecting final visual outcome in AK patients treated with PHMB

 Methods: In these interventional case series study, 27 eyes of 25 patients with AK received PHMB 0.02% and divided into two groups according to the final visual acuity (VA) VA equal to or greater than 20/25 and VA less than 20/25. Two groups were evaluated for the effectiveness of PHMB in treatment of AK.

 Results: Before treatment, more than 85% of the eyes had VA of less than 20/25 whilst after treatment final VA was 20/25 or better in 66.7% of eyes. VA regressed in 14.8% of the eyes during follow-up and improved or remained the same in more than 85% of eyes. Patients with deep stromal keratitis or a ring infiltrate had more than a 28-fold increase in the odds of a visual outcome worse than 20/25 [odd ratio (OR), 28.0 95% CI, 3.3-240.8, p=0.001]. Patients with Initial VA<20/40 had a 9-fold increase in the odds of a visual outcome worse than 20/25 (OR, 8.6 95% CI, 1.2-59.8, p=0.003). Longer duration of symptoms (≥ 3 weeks) or the medication used prior the first visit were not associated with poorer final VA (p>0.05). Five eyes (18.5%) finally required keratoplasty.

 Conclusion: Initial stage of corneal involvement at presentation was the most predictive factor for final visual outcome in AK. Although PHMB, even as monotherapy, is effective in treatment of AK, a remarkable proportion of patients still suffer a final grim visual outcome which requires aggressive treatments.

  

 Iranian Journal of Ophthalmology 201426(1):41-47 © 2014 by the Iranian Society of Ophthalmology

Keywords: Acanthamoeba Keratitis, Polyhexamethylene Biguanide, Visual Acuity
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Type of Study: Original | Subject: Anterior segment
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Rahimi F, Rafizadeh S M, Beheshtnejad A H, Hashemian M N, Zare M A, Kohansal S, et al . Clinical Outcomes in Acanthamoeba Keratitis Treated with Polyhexamethylene Biguanide as Monotherapy. Iranian Journal of Ophthalmology. 2014; 26 (1) :41-47
URL: http://irjo.org/article-1-899-en.html


Volume 26, Issue 1 (Iranian Journal of Ophthalmology 2014) Back to browse issues page
مجله چشم پزشکی ایران Iranian Journal of Ophthalmology
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