F.I. Proctor Foundation, University of California, San Francisco, San Francisco, CA 94143-0944, USA.
Cornea. 2011 Dec;30(12):1363-8. doi: 10.1097/ICO.0b013e31820f7763.
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.
An online survey was sent to all subscribers of The Cornea Society via the kera-net listserv. Descriptive statistics were performed.
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.
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.
棘阿米巴角膜炎的治疗对眼科医生来说仍然具有挑战性。我们对角膜学会的成员进行了一项调查，以征求专家对棘阿米巴角膜炎的诊断和治疗的意见。
通过 kera-net 列表服务向角膜学会的所有订阅者发送了在线调查。进行了描述性统计分析。
82 名参与者完成了在线调查。在 82 名回答者中，76.8%的人将临床检查和培养结合在他们的诊断策略中，43.9%的人使用共焦显微镜。大多数受访者（97.6%）过去曾使用多种药物联合治疗棘阿米巴角膜炎，而较小比例（47.6%）曾使用单一药物治疗。受访者最常选择聚六亚甲基双胍作为单一疗法的理想选择（51.4%），而双胍和脒类药物联合治疗作为联合疗法的理想选择（37.5%）。大多数受访者（62.2%）报告至少在某些时候使用局部皮质类固醇治疗棘阿米巴角膜炎。角膜移植术是大多数受访者（75.6%）考虑的一种选择，尽管大多数（85.5%）只有在药物治疗失败后才会进行手术。
目前对棘阿米巴角膜炎的诊断和治疗存在广泛的实践模式。由于缺乏足够有力的比较有效性研究和临床试验，使得很难为这种疾病做出基于证据的决策。
