Journal of Ophthalmic and Vision Research

ORIGINAL ARTICLE
Year
: 2015  |  Volume : 10  |  Issue : 2  |  Page : 106--111

Chlorhexidine monotherapy with adjunctive topical corticosteroids for acanthamoeba keratitis


Firoozeh Rahimi, Seyed Mohammad Nasser Hashemian, Mohammadreza Falah Tafti, Mohammadali Zare Mehjerdi, Mona Seyed Safizadeh, Elias Khalili Pour, Bahram Bohrani Sefidan 
 Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran

Correspondence Address:
Bahram Bohrani Sefidan
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran 13366
Iran

Purpose: To assess the efficacy of chlorhexidine monotherapy for Acanthamoeba keratitis, and to determine the therapeutic outcomes of concomitant topical corticosteroids. Methods: In this prospective interventional case series, 31 eyes of 31 patients with Acanthamoeba keratitis (AK) were treated with chlorhexidine 0.02% as monotherapy, from April 2010 to April 2011. The diagnosis of AK was made based on clinical manifestations and positive confocal microscopic (confoscan 3.4, Nidek Co. Ltd., Gamagori, Japan) results. We report the percentage of a favorable clinical response within two weeks of initiating treatment, worsening of the infection while receiving chlorhexidine, recovery of visual acuity (VA), duration of treatment with chlorhexidine and corticosteroids, necessity for addition of other anti-Acanthamoeba agents, presence of corneal scar at the end of the treatment, and need for penetrating keratoplasty (PK). Results: Two weeks after initiation of chlorhexidine, improvement in signs and symptoms was observed in 26 (83.9%) patients but 3 eyes required the addition of propamidine. After initial improvement in one patient, the infection worsened, necessitating the addition of Polyhexamethylene Biguanide (PHMB) and propamidine. A total of 26 (83.9%) patients received topical corticosteroids with mean duration of 65.8 ± 45.1 days. In 22 (71%) eyes, final visual acuity was≥0.80. Improved VA occurred in 29 eyes (93.5%). Optical PK was considered in 3 (9.7%) eyes and a corneal scar developed in 8 (25.8%) eyes. Conclusion: Chlorhexidine is effective for monotherapy in AK and could be a good choice for initiating treatment. After the initial response to anti-Acanthamoeba agents, corticosteroids can be used as adjunctive therapy depending on the clinical condition.


How to cite this article:
Rahimi F, Hashemian SM, Tafti MF, Mehjerdi MZ, Safizadeh MS, Pour EK, Sefidan BB. Chlorhexidine monotherapy with adjunctive topical corticosteroids for acanthamoeba keratitis.J Ophthalmic Vis Res 2015;10:106-111


How to cite this URL:
Rahimi F, Hashemian SM, Tafti MF, Mehjerdi MZ, Safizadeh MS, Pour EK, Sefidan BB. Chlorhexidine monotherapy with adjunctive topical corticosteroids for acanthamoeba keratitis. J Ophthalmic Vis Res [serial online] 2015 [cited 2020 Feb 29 ];10:106-111
Available from: http://www.jovr.org/article.asp?issn=2008-322X;year=2015;volume=10;issue=2;spage=106;epage=111;aulast=Rahimi;type=0