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棘阿米巴角膜炎的挑战:综述

Challenges in Acanthamoeba Keratitis: A Review.

作者信息

Varacalli Giuseppe, Di Zazzo Antonio, Mori Tommaso, Dohlman Thomas H, Spelta Sara, Coassin Marco, Bonini Stefano

机构信息

Ophthalmology Operative Complex Unit, Campus Bio-Medico University Hospital, 00128 Rome, Italy.

Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA.

出版信息

J Clin Med. 2021 Mar 1;10(5):942. doi: 10.3390/jcm10050942.

Abstract

To review challenges in the diagnosis and management of Acanthamoeba keratitis (AK), along with prognostic factors, in order to help ophthalmologists avoid misdiagnosis, protracted treatment periods, and long-term negative sequelae, with an overarching goal of improving patient outcomes and quality of life, we examined AK studies published between January 1998 and December 2019. All manuscripts describing clinical manifestations, diagnosis, treatment, prognosis, and challenges in short- and long-term management were included. The diagnosis of AK is often challenging. An increased time between symptom onset and the initiation of appropriate therapy is associated with poorer visual outcomes. The timely initiation of standardized antiamoebic therapies improves visual outcomes, decreases the duration of treatment, and reduces the chances of needing surgical intervention. In clinical practice, AK diagnosis is often missed or delayed, leading to poorer final visual outcomes and a negative impact on patient morbidity and quality of life.

摘要

为了回顾棘阿米巴角膜炎(AK)诊断和管理方面的挑战以及预后因素,以帮助眼科医生避免误诊、延长治疗周期和长期负面后遗症,最终目标是改善患者预后和生活质量,我们研究了1998年1月至2019年12月发表的AK研究。纳入了所有描述临床表现、诊断、治疗、预后以及短期和长期管理挑战的手稿。AK的诊断通常具有挑战性。症状出现到开始适当治疗之间的时间增加与较差的视力预后相关。及时开始标准化抗阿米巴治疗可改善视力预后,缩短治疗时间,并减少需要手术干预的机会。在临床实践中,AK诊断常常被漏诊或延迟,导致最终视力预后较差,并对患者发病率和生活质量产生负面影响。

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