Outcome of photodynamic therapy with Rose Bengal in conjunction with topical PHMB and chlorhexidine combination in Acanthamoeba keratitis.

PURPOSE

To report the outcome of Acanthamoeba keratitis, with early addition of Photo-dynamic antimicrobial therapy with Rose Bengal (PDAT-RB) to the medical treatment (combination of 0.02% Polyhexamethylene Biguanide (PH)and 0.02% chlorhexidine(CH)).

METHODS

Patients were recruited based on the infiltrate size being < 8 mm and limited to the mid stroma, < 300µ, and confirmed microbiological diagnosis. Along with the continuation of PHMB + CH, patients were also treated with PDAT-RB twice with a gap of one week using 0.1% w/v RB and green LED (525 nm) array immediately after the confirmation of diagnosis.

RESULTS

A total of 14 patients were enrolled. All the enrolled patients received adjuvant PDAT-RB within 5 (2.5 to 11) days of diagnosis. The average diameter and median depth of the infiltrate were 5.7 ± 1.56(V), 5.9 ± 1.38(H) mm, and 250 (250 to 300)µ, respectively. The mean LogMAR visual acuity at the time of presentation was 2.52 ± 0.95. Out of 14 enrolled patients, infection was resolved in 12 (85.7%) patients, whereas 2 (14.3%) patients needed TPK. The median days to resolve were 110 (67 to 150) days. The final mean LogMAR Visual acuity at the end of the follow-up was 1.60 ± 1.3.

CONCLUSION

The study demonstrates the effective resolution of Acanthamoeba keratitis when treated with early adjuvant photodynamic antimicrobial therapy using Rose Bengal (PDAT-RB).