Infectious keratitis: A review

Maria Cabrera-Aguas, Pauline Khoo, Stephanie L Watson, Maria Cabrera-Aguas, Pauline Khoo, Stephanie L Watson

Abstract

Globally, infectious keratitis is the fifth leading cause of blindness. The main predisposing factors include contact lens wear, ocular injury and ocular surface disease. Staphylococcus species, Pseudomonas aeruginosa, Fusarium species, Candida species and Acanthamoeba species are the most common causal organisms. Culture of corneal scrapes is the preferred initial test to identify the culprit organism. Polymerase chain reaction (PCR) tests and in vivo confocal microscopy can complement the diagnosis. Empiric therapy is typically commenced with fluoroquinolones, or fortified antibiotics for bacterial keratitis; topical natamycin for fungal keratitis; and polyhexamethylene biguanide or chlorhexidine for acanthamoeba keratitis. Herpes simplex keratitis is mainly diagnosed clinically; however, PCR can also be used to confirm the initial diagnosis and in atypical cases. Antivirals and topical corticosteroids are indicated depending on the corneal layer infected. Vision impairment, blindness and even loss of the eye can occur with a delay in diagnosis and inappropriate antimicrobial therapy.

Keywords: acanthamoeba keratitis; bacterial keratitis; fungal keratitis; infectious keratitis; viral keratitis.

Conflict of interest statement

The authors declare no conflicts of interest.

© 2022 The Authors. Clinical & Experimental Ophthalmology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Ophthalmologists.

Figures

FIGURE 1
FIGURE 1
Slit lamp image of a case of bacterial keratitis in a contact lens wearer with typical features; there is a central corneal infiltrate with an overlying epithelial defect and conjunctival hyperaemia
FIGURE 2
FIGURE 2
Bacterial keratitis in a failed corneal graft with a broken suture. The graft is oedematous and inferiorly a white infiltrate and larger epithelial defect can be seen within the graft. There is peripheral host vascularisation and conjunctival hyperaemia
FIGURE 3
FIGURE 3
Slit lamp image of a protruding cornea with bacterial keratitis. The patient has keratoconus complicated by corneal hydrops and then bacterial infection. Scattered infiltrates can be seen across most of the protuberant cornea and the conjunctiva is hyperaemic
FIGURE 4
FIGURE 4
(A) Dendritic ulcer in epithelial herpes simplex keratitis stained with fluorescein. (B) Stromal herpes simplex keratitis with lipid keratopathy and vascularisation. (C) Stromal herpes simplex keratitis with ulceration. (D) Herpes simplex keratouveitis with anterior chamber cells
FIGURE 5
FIGURE 5
Corneal ulcer and infiltrates in a case Candida keratitis; the signs are similar to those found in bacterial keratitis
FIGURE 6
FIGURE 6
Ring infiltrate in acanthamoeba keratitis
FIGURE 7
FIGURE 7
Advanced acanthamoeba keratitis, scattered stromal infiltrates with corneal vascularisation and conjunctival hyperaemia are noted
FIGURE 8
FIGURE 8
In vivo confocal microscopy of acanthamoeba keratitis

References

    1. Durand ML, Barshak MB, Chodosh J. Infectious keratitis in 2021. JAMA. 2021;326(13):1319‐1320.
    1. Ung L, Bispo PJM, Shanbhag SS, Gilmore MS, Chodosh J. The persistent dilemma of microbial keratitis: global burden, diagnosis, and antimicrobial resistance. Surv Ophthalmol. 2019;64(3):255‐271.
    1. Whitcher JP, Srinivasan M, Upadhyay MP. Corneal blindness: a global perspective. Bull World Health Organ. 2001;79:214‐221.
    1. Flaxman SR, Bourne RRA, Resnikoff S, et al. Global causes of blindness and distance vision impairment 1990‐2020: a systematic review and meta‐analysis. Lancet Glob Health. 2017;5(12):e1221‐e1234.
    1. Ung L, Acharya NR, Agarwal T, et al. Infectious corneal ulceration: a proposal for neglected tropical disease status. Bull World Health Organ. 2019;97(12):854‐856.
    1. Ting DSJ, Ho CS, Cairns J, et al. 12‐year analysis of incidence, microbiological profiles and in vitro antimicrobial susceptibility of infectious keratitis: the Nottingham infectious keratitis study. Br J Ophthalmol. 2021;105(3):328‐333.
    1. Green M, Carnt N, Apel A, et al. Queensland microbial keratitis database: 2005–2015. Br J Ophthalmol. 2019;103(10):1481‐1486.
    1. Watson SL, Gatus BJ, Cabrera‐Aguas M, et al. Bacterial ocular surveillance system (BOSS) Sydney, Australia 2017‐2018. Commun Dis Intell. 2020;44. doi:10.33321/cdi.2020.44.86
    1. Cabrera‐Aguas M, Khoo P, George CRR, Lahra MM, Watson SL. Antimicrobial resistance trends in bacterial keratitis over 5 years in Sydney, Australia. Clin Experiment Ophthalmol. 2020;48(2):183‐191.
    1. Khoo P, Cabrera‐Aguas MP, Nguyen V, Lahra MM, Watson SL. Microbial keratitis in Sydney, Australia: risk factors, patient outcomes, and seasonal variation. Graefes Arch Clin Exp Ophthalmol. 2020;258(8):1745‐1755.
    1. Miller D, Cavuoto KM, Alfonso EC. Bacterial keratitis. In: Das S, Jhanji V, eds. Infections of the Cornea and Conjunctiva. Springer Singapore; 2021:85‐104.
    1. Lin A, Rhee MK, Akpek EK, et al. Bacterial keratitis preferred practice pattern®. Ophthalmology. 2019;126(1):P1‐P55.
    1. Green M, Apel A, Stapleton F. Microbial keratitis in a tertiary Centre in Queensland, Australia (1999‐2015). Clin Exp Optom. 2021;104(4):486‐490.
    1. Austin A, Lietman T, Rose‐Nussbaumer J. Update on the management of infectious keratitis. Ophthalmology. 2017;124(11):1678‐1689.
    1. eTG complete [Internet] . Melbourne (VIC) 2019. Available from: .
    1. Cabrera‐Aguas M, Kerdraon Y, Symes RJ, et al. Development, implementation, and evaluation of treatment guidelines for herpes simplex keratitis in Sydney, Australia. Cornea. 2020;39(7):834‐840.
    1. Tabbara KF, El‐Asrar AMA, Khairallah M. Ocular Infections: Infectious Keratitis. Springer; 2014.
    1. Garg P, Roy A. Clinical work‐up of corneal ulcers. In: Das S, Jhanji V, eds. Infections of the Cornea and Conjunctiva. Springer Singapore; 2021:75‐84.
    1. Ngo J, Khoo P, Watson SL. Improving the efficiency and the technique of the corneal scrape procedure via an evidence based instructional video at a quaternary referral eye hospital. Curr Eye Res. 2020;45(5):529‐534.
    1. Ferreira CS, Figueira L, Moreira‐Gonçalves N, Moreira R, Torrão L, Falcão‐Reis F. Clinical and microbiological profile of bacterial microbial keratitis in a Portuguese tertiary referral center‐where are we in 2015? Eye Contact Lens. 2018;44(1):15‐20.
    1. Das S, Samantaray R, Mallick A, Sahu SK, Sharma S. Types of organisms and in‐vitro susceptibility of bacterial isolates from patients with microbial keratitis: a trend analysis of 8 years. Indian J Ophthalmol. 2019;67(1):49‐53.
    1. Khor HG, Cho I, Lee KRCK, Chieng LL. Spectrum of microbial keratitis encountered in the tropics. Eye Contact Lens. 2020;46(1):17‐23.
    1. Soleimani M, Tabatabaei SA, Masoumi A, et al. Infectious keratitis: trends in microbiological and antibiotic sensitivity patterns. Eye (Lond). 2021;35(11):3110‐3115.
    1. Luiza Manhezi Shin de O, Tatiana T, Juliana Mika K, et al. Research Square. 2021.
    1. Liu HY, Hopping GC, Vaidyanathan U, Ronquillo YC, Hoopes PC, Moshirfar M. Polymerase chain reaction and its application in the diagnosis of infectious keratitis. Med Hypothesis Discov Innov Ophthalmol. 2019;8(3):152‐155.
    1. Somerville TF, Corless CE, Sueke H, Neal T, Kaye SB. 16S ribosomal RNA PCR versus conventional diagnostic culture in the investigation of suspected bacterial keratitis. Translational vision. Sci Technol. 2020;9(13):2.
    1. Robaei D, Chan UT, Khoo P, et al. Corneal biopsy for diagnosis of recalcitrant microbial keratitis. Graefes Arch Clin Exp Ophthalmol. 2018;256(8):1527‐1533.
    1. Hoffman JJ, Dart JKG, De SK, et al. Comparison of culture, confocal microscopy and PCR in routine hospital use for microbial keratitis diagnosis. Eye. 2021. doi:10.1038/s41433-021-01812-7
    1. Taravati P, Lam D, Van Gelder RN. Role of molecular diagnostics in ocular microbiology. Curr Ophthalmol Rep. 2013;1(4):181‐189.
    1. Kobayashi T, Suzuki T, Okajima Y, et al. Metagenome techniques for detection of pathogens causing ocular infection. Report. 2021;4(1):6.
    1. Eleinen KG, Mohalhal AA, Elmekawy HE, et al. Polymerase chain reaction‐guided diagnosis of infective keratitis ‐ a hospital‐based study. Curr Eye Res. 2012;37(11):1005‐1011.
    1. Kim E, Chidambaram JD, Srinivasan M, et al. Prospective comparison of microbial culture and polymerase chain reaction in the diagnosis of corneal ulcer. Am J Ophthalmol. 2008;146(5):714.e1‐723.e1.
    1. Sahay P, Goel S, Nagpal R, et al. Infectious keratitis caused by rare and emerging micro‐organisms. Curr Eye Res. 2020;45(7):761‐773.
    1. Shrestha NK, Tuohy MJ, Hall GS, Reischl U, Gordon SM, Procop GW. Detection and differentiation of mycobacterium tuberculosis and nontuberculous mycobacterial isolates by real‐time PCR. J Clin Microbiol. 2003;41(11):5121‐5126.
    1. Ong HS, Sharma N, Phee LM, Mehta JS. Atypical microbial keratitis. Ocul Surf. 2021. Epub ahead of print. doi:10.1016/j.jtos.2021.11.001
    1. Mohammed ISK, Jeng BH. Atypical mycobacterial keratitis. In: Das S, Jhanji V, eds. Infections of the Cornea and Conjunctiva. Springer Singapore; 2021:105‐113.
    1. Sahay P, Maharana PK, Sharma N. Nocardia keratitis. In: Das S, Jhanji V, eds. Infections of the Cornea and Conjunctiva. Springer Singapore; 2021:115‐123.
    1. Soleimani M, Masoumi A, Khodavaisy S, Heidari M, Haydar AA, Izadi A. Current diagnostic tools and management modalities of Nocardia keratitis. J Ophthalmic Inflamm Infect. 2020;10(1):36.
    1. Willcox MDP. Characterization of the normal microbiota of the ocular surface. Exp Eye Res. 2013;117:99‐105.
    1. Khoo P, Cabrera‐Aguas M, Robaei D, Lahra MM, Watson S. Microbial keratitis and ocular surface disease: a 5‐year study of the microbiology, risk factors and clinical outcomes in Sydney, Australia. Curr Eye Res. 2019;44(11):1195‐1202.
    1. Ung L, Chodosh J. Foundational concepts in the biology of bacterial keratitis. Exp Eye Res. 2021;209:108647.
    1. Goldstein MH, Kowalski RP, Gordon YJ. Emerging fluoroquinolone resistance in bacterial keratitis. Ophthalmology. 1999;106(7):1313‐1318.
    1. Asbell PA, Sanfilippo CM, Sahm DF, DeCory HH. Trends in antibiotic resistance among ocular microorganisms in the United States from 2009 to 2018. JAMA Ophthalmol. 2020;138(5):439‐450.
    1. Asbell PA, Sanfilippo CM, DeCory HH. Analysis of longitudinal antibiotic susceptibility trends in staphylococci: results from 12 years of the ARMOR study. Invest Ophthalmol Vis Sci. 2021;62(8):2684.
    1. Srinivasan M, Mascarenhas J, Rajaraman R, et al. The steroids for corneal ulcers trial (SCUT): secondary 12‐month clinical outcomes of a randomized controlled trial. Am J Ophthalmol. 2014;157(2):327‐33.e3.
    1. Khoo P, Cabrera‐Aguas M, Watson SL. Topical steroids as adjunctive therapy for bacterial keratitis: evidence from a retrospective case series of 313 cases. Asia‐Pac J Ophthalmol. 2020;9(5):398‐403.
    1. Yin J, Singh RB, Al Karmi R, et al. Outcomes of cyanoacrylate tissue adhesive application in corneal thinning and perforation. Cornea. 2019;38(6):668‐673.
    1. Tan J, Wechsler AW, Watson S. Long‐term adhesion of cyanoacrylate on human cornea. Clin Experiment Ophthalmol. 2014;42(8):791‐793.
    1. Tan J, Foster LJR, Watson SL. Corneal sealants in clinical use: a systematic review. Curr Eye Res. 2020;45(9):1025‐1030.
    1. Tan J, Li Y‐C, Foster J, et al. The efficacy of N‐Butyl‐2 cyanoacrylate (Histoacryl) for sealing corneal perforation: a clinical case series and review of the literature. J Clin Exp Ophthalmol. 2015;6(2):420.
    1. Williams K, Keane M, Galettis R, Jones VJ, Mills RAD, Coster DJ. The Australian Corneal Graft Registry. Department Ophthalmology, Flinders University, South Australian Health and Medical Research Institute; 2018.
    1. Ung L, Bispo PJM, Doan T, et al. Clinical metagenomics for infectious corneal ulcers: rags to riches? Ocul Surf. 2020;18(1):1‐12.
    1. Seitzman GD, Hinterwirth A, Zhong L, et al. Metagenomic deep sequencing for the diagnosis of corneal and external disease infections. Ophthalmology. 2019;126(12):1724‐1726.
    1. Kuo MT, Hsu BW, Lin YS, et al. Comparisons of deep learning algorithms for diagnosing bacterial keratitis via external eye photographs. Sci Rep. 2021;11(1):24227.
    1. Tiwari M, Piech C, Baitemirova M, et al. Differentiation of active corneal infections from healed scars using deep learning. Ophthalmology. 2022;129(2):139‐146.
    1. Koyama A, Miyazaki D, Nakagawa Y, et al. Determination of probability of causative pathogen in infectious keratitis using deep learning algorithm of slit‐lamp images. Sci Rep. 2021;11(1):22642.
    1. Ghosh AK, Thammasudjarit R, Jongkhajornpong P, Attia J, Thakkinstian A. Deep learning for discrimination between fungal keratitis and bacterial keratitis: deepkeratitis. Cornea. 2022;41(5):616‐622.
    1. Cabrera‐Aguas M, Robaei D, McCluskey P, Watson S. Clinical translation of recommendations from randomized trials for management of herpes simplex virus keratitis. Clin Experiment Ophthalmol. 2018;46(9):1008‐1016.
    1. Guess S, Stone DU, Chodosh J. Evidence‐based treatment of herpes simplex virus keratitis: a systematic review. Ocul Surf. 2007;5(3):240‐250.
    1. Watson S, Cabrera‐Aguas M, Khoo P. Common eye infections. Aust Prescr. 2018;41(3):67‐72.
    1. Cabrera‐Aguas M, Khoo P, McCluskey P, et al. Viral ocular infections. In: Rezaei N, ed. Encyclopedia of Infection and Immunity. Oxford: Elsevier; 2022. p. 219‐33.
    1. Farooq A, Shukla D. Herpes simplex epithelial and stromal keratitis: an epidemiologic update. Surv Ophthalmol. 2012;57(5):448‐462.
    1. Tsatsos M, MacGregor C, Athanasiadis I, Moschos MM, Hossain P, Anderson D. Herpes simplex virus keratitis: an update of the pathogenesis and current treatment with oral and topical antiviral agents. Clin Experiment Ophthalmol. 2016;44(9):824‐837.
    1. Azher TN, Yin XT, Tajfirouz D, Huang A, Stuart P. Herpes simplex keratitis: challenges in diagnosis and clinical management. Clin Ophthalmol. 2017;11:185‐191.
    1. White ML, Chodosh J. Herpes Simplex Virus Keratitis: A Treatment Guideline San Francisco: Hoskins Center for Quality Eye Care. American Academy of Ophthalmology; 2014.
    1. Sibley D, Larkin DFP. Update on herpes simplex keratitis management. Eye (Lond). 2020;34(12):2219‐2226.
    1. Arshad S, Petsoglou C, Lee T, al‐Tamimi A, Carnt NA. 20 years since the herpetic eye disease study: lessons, developments and applications to clinical practice. Clin Exp Optom. 2021;104(3):396‐405.
    1. Schwartz GS, Holland EJ. Oral acyclovir for the management of herpes simplex virus keratitis in children. Ophthalmology. 2000;107(2):278‐282.
    1. Valerio GS, Lin CC. Ocular manifestations of herpes simplex virus. Curr Opin Ophthalmol. 2019;30(6):525‐531.
    1. El‐Aal AM, El Sayed M, Mohammed E, et al. Evaluation of herpes simplex detection in corneal scrapings by three molecular methods. Curr Microbiol. 2006;52(5):379‐382.
    1. Kowalski RP, Thompson PP, Kinchington PR, Gordon YJ. Evaluation of the SmartCycler II system for real‐time detection of viruses and chlamydia from ocular specimens. Arch Ophthalmol. 2006;124(8):1135‐1139.
    1. Subhan S, Jose RJ, Duggirala A, et al. Diagnosis of herpes simplex virus‐1 keratitis: comparison of Giemsa stain, immunofluorescence assay and polymerase chain reaction. Curr Eye Res. 2004;29(2–3):209‐213.
    1. Cabrera‐Aguas M, Kerdraon Y, Watson SL. Diagnosis using polymerase chain reaction and outcomes in herpes simplex keratitis. Acta Ophthalmol. 2021;99(5):e770‐e771.
    1. Li JY. Herpes zoster ophthalmicus: acute keratitis. Curr Opin Ophthalmol. 2018;29(4):328‐333.
    1. Niederer RL, Meyer JJ, Liu K, Danesh‐Meyer HV. Herpes zoster ophthalmicus clinical presentation and risk factors for loss of vision. Am J Ophthalmol. 2021;226:83‐89.
    1. Jeng BH. Herpes zoster eye disease: new ways to combat an old foe? Ophthalmology. 2018;125(11):1671‐1674.
    1. Chan AY, Conrady CD, Ding K, Dvorak JD, Stone DU. Factors associated with age of onset of herpes zoster ophthalmicus. Cornea. 2015;34(5):535‐540.
    1. Davies EC, Pavan‐Langston D, Chodosh J. Herpes zoster ophthalmicus: declining age at presentation. Br J Ophthalmol. 2016;100(3):312‐314.
    1. de Melker H, Berbers G, Hahne S, et al. The epidemiology of varicella and herpes zoster in The Netherlands: implications for varicella zoster virus vaccination. Vaccine. 2006;24(18):3946‐3952.
    1. de Boer PT, van Lier A, de Melker H, et al. Cost‐effectiveness of vaccination of immunocompetent older adults against herpes zoster in The Netherlands: a comparison between the adjuvanted subunit and live‐attenuated vaccines. BMC Med. 2018;16(1):228.
    1. Cohen EJ, Hochman JS, Troxel AB, Colby KA, Jeng BH. Zoster eye disease study: rationale and design. Cornea. 2022;41(5):562‐571.
    1. Liesegang TJ. Herpes zoster ophthalmicus natural history, risk factors, clinical presentation, and morbidity. Ophthalmology. 2008;115(2 Suppl):S3‐S12.
    1. Kawai K, VoPham T, Drucker A, Curhan SG, Curhan GC. Ultraviolet radiation exposure and the risk of herpes zoster in three prospective cohort studies. Mayo Clin Proc. 2020;95(2):283‐292.
    1. Marra F, Parhar K, Huang B, Vadlamudi N. Risk factors for herpes zoster infection: a meta‐analysis. Open Forum Infect Dis. 2020;7(1):ofaa005.
    1. Lu LM, McGhee CNJ, Sims JL, et al. High rate of recurrence of herpes zoster‐related ocular disease after phacoemulsification cataract surgery. J Cataract Refract Surg. 2019;45(6):810‐815.
    1. Marra F, Chong M, Najafzadeh M. Increasing incidence associated with herpes zoster infection in British Columbia, Canada. BMC Infect Dis. 2016;16(1):589.
    1. Aggarwal S, Cavalcanti BM, Pavan‐Langston D. Treatment of pseudodendrites in herpes zoster ophthalmicus with topical ganciclovir 0.15% gel. Cornea. 2014;33(2):109‐113.
    1. Inata K, Miyazaki D, Uotani R, et al. Effectiveness of real‐time PCR for diagnosis and prognosis of varicella‐zoster virus keratitis. Jpn J Ophthalmol. 2018;62(4):425‐431.
    1. Colin J, Prisant O, Cochener B, Lescale O, Rolland B, Hoang‐Xuan T. Comparison of the efficacy and safety of valaciclovir and acyclovir for the treatment of herpes zoster ophthalmicus. Ophthalmology. 2000;107(8):1507‐1511.
    1. Beutner KR, Friedman DJ, Forszpaniak C, Andersen PL, Wood MJ. Valaciclovir compared with acyclovir for improved therapy for herpes zoster in immunocompetent adults. Antimicrob Agents Chemother. 1995;39(7):1546‐1553.
    1. Tyring SK, Beutner KR, Tucker BA, Anderson WC, Crooks RJ. Antiviral therapy for herpes zoster: randomized, controlled clinical trial of valacyclovir and famciclovir therapy in immunocompetent patients 50 years and older. Arch Fam Med. 2000;9(9):863‐869.
    1. Jain N, Cabrera‐Aguas M, Watson S. Clinical translation of recommendations from clinical trials for the management of herpes zoster ophthalmicus. Clin Experiment Ophthalmol. 2019;47(S1):96.
    1. Hu AY, Strauss EC, Holland GN, et al. Late varicella‐zoster virus dendriform keratitis in patients with histories of herpes zoster ophthalmicus. Am J Ophthalmol. 2010;149(2):214‐20.e3.
    1. Mortemousque B. Chronic recurrent varicella‐zoster virus keratitis confirmed by polymerase chain reaction testing. Am J Ophthalmol. 2006;141(4):782 author reply.
    1. Magone MT, Nasser RE, Cevallos AV, Margolis TP. Chronic recurrent varicella‐zoster virus keratitis confirmed by polymerase chain reaction testing. Am J Ophthalmol. 2005;139(6):1135‐1136.
    1. Bhartiya P, Daniell M, Constantinou M, Islam FMA, Taylor HR. Fungal keratitis in Melbourne. Clin Experiment Ophthalmol. 2007;35(2):124‐130.
    1. Cabrera‐Aguas M, Khoo P, McCluskey P, et al. Fungal ocular infections. In: Rezaei N, ed. Encyclopedia of Infection and Immunity. Oxford: Elsevier; 2022. p. 234‐45.
    1. Watson SL, Cabrera‐Aguas M, Keay L, Khoo P, McCall D, Lahra MM. The clinical and microbiological features and outcomes of fungal keratitis over 9 years in Sydney, Australia. Mycoses. 2020;63(1):43‐51.
    1. Kumar RL, Cruzat A, Hamrah P. Current state of in vivo confocal microscopy in management of microbial keratitis. Semin Ophthalmol. 2010;25(5–6):166‐170.
    1. Maharana P, Sharma N, Nagpal R, Jhanji V, Das S, Vajpayee RB. Recent advances in diagnosis and management of Mycotic Keratitis. Indian J Ophthalmol. 2016;64(5):346‐357.
    1. Srinivasan M. Fungal keratitis. Curr Opin Ophthalmol. 2004;15(4):321‐327.
    1. Klotz SA, Penn CC, Negvesky GJ, Butrus SI. Fungal and parasitic infections of the eye. Clin Microbiol Rev. 2000;13(4):662‐685.
    1. Qiao G, Ling J, Wong T, Yeung SN, Lovieno A. Candida keratitis: epidemiology, management, and clinical outcomes. Cornea. 2020;39(7):801‐805.
    1. Donovan C, Arenas E, Ayyala RS, et al. Fungal keratitis: mechanisms of infection and management strategies. Surv Ophthalmol. 2021;67:758‐769.
    1. Thomas PA, Geraldine P. Infectious keratitis. Curr Opin Infect Dis. 2007;20(2):129‐141.
    1. Roy A, Srinivasan M, Das S. Fungal Keratitis. In: Das S, Jhanji V, eds. Infections of the Cornea and Conjunctiva. Springer Singapore; 2021:149‐175.
    1. Bakken IM, Jackson CJ, Utheim TP, et al. The use of in vivo confocal microscopy in fungal keratitis ‐ Progress and challenges. Ocul Surf. 2022;24:103‐118.
    1. Kheirkhah A, Syed ZA, Satitpitakul V, et al. Sensitivity and specificity of laser‐scanning in vivo confocal microscopy for filamentous fungal keratitis: role of observer experience. Am J Ophthalmol. 2017;179:81‐89.
    1. Hau SC, Dart JK, Vesaluoma M, et al. Diagnostic accuracy of microbial keratitis with in vivo scanning laser confocal microscopy. Br J Ophthalmol. 2010;94(8):982‐987.
    1. Soliman W, Mohamed TA. Spectral domain anterior segment optical coherence tomography assessment of pterygium and pinguecula. Acta Ophthalmol. 2012;90:461‐465.
    1. Prajna NV, Krishnan T, Rajaraman R, et al. Effect of oral voriconazole on fungal keratitis in the mycotic ulcer treatment trial II (MUTT II): a randomized clinical trial. JAMA Ophthalmol. 2016;134(12):1365‐1372.
    1. Sharma N, Sahay P, Maharana PK, et al. Management algorithm for fungal keratitis: the TST (topical, systemic, and targeted therapy) protocol. Cornea. 2019;38(2):141‐145.
    1. Sabhapandit S, Murthy SI, Garg P, Korwar V, Vemuganti GK, Sharma S. Microsporidial stromal keratitis: clinical features, unique diagnostic criteria, and treatment outcomes in a large case series. Cornea. 2016;35(12):1569‐1574.
    1. Das S, Priyadarshini SR, Roy A. Microsporidial Keratitis. In: Das S, Jhanji V, eds. Infections of the Cornea and Conjunctiva. Springer Singapore; 2021:137‐147.
    1. de Lacerda AG, Lira M. Acanthamoeba keratitis: a review of biology, pathophysiology and epidemiology. Ophthalmic Physiol Opt. 2021;41(1):116‐135.
    1. Jain R, Garg P, Motukupally SR, et al. Clinico‐microbiological review of non‐contact‐lens‐associated Acanthamoeba keratitis. Seminars in Ophthalmology. Taylor & Francis; 2015.
    1. Hassan F, Bhatti A, Desai R, Barua A. Analysis from a year of increased cases of Acanthamoeba keratitis in a large teaching hospital in the UK. Cont Lens Anterior Eye. 2019;42(5):506‐511.
    1. Höllhumer R, Keay L, Watson S. Acanthamoeba keratitis in Australia: demographics, associated factors, presentation and outcomes: a 15‐year case review. Eye (Lond). 2020;34(4):725‐732.
    1. Bharathi M, Ramakrishnan R, Meenakshi R, et al. Microbial keratitis in South India: influence of risk factors, climate, and geographical variation. Ophthalmic Epidemiol. 2007;14(2):61‐69.
    1. Chin J, Young AL, Hui M, Jhanji V. Acanthamoeba keratitis: 10‐year study at a tertiary eye care center in Hong Kong. Cont Lens Anterior Eye. 2015;38(2):99‐103.
    1. Lorenzo‐Morales J, Martín‐Navarro CM, López‐Arencibia A, Arnalich‐Montiel F, Piñero JE, Valladares B. Acanthamoeba keratitis: an emerging disease gathering importance worldwide? Trends Parasitol. 2013;29(4):181‐187.
    1. Mathers WD, Sutphin JE, Lane JA, Folberg R. Correlation between surface water contamination with amoeba and the onset of symptoms and diagnosis of amoeba‐like keratitis. Br J Ophthalmol. 1998;82(10):1143‐1146.
    1. Yoder JS, Verani J, Heidman N, et al. Acanthamoeba keratitis: the persistence of cases following a multistate outbreak. Ophthalmic Epidemiol. 2012;19(4):221‐225.
    1. Alfawaz A. Radial keratoneuritis as a presenting sign in acanthamoeba keratitis. Middle East Afr J Ophthalmol. 2011;18(3):252‐255.
    1. Feist RM, Sugar J, Tessler H. Radial keratoneuritis in Pseudomonas keratitis. Arch Ophthalmol. 1991;109(6):774‐775.
    1. Villani E, Baudouin C, Efron N, et al. In vivo confocal microscopy of the ocular surface: from bench to bedside. Curr Eye Res. 2014;39(3):213‐231.
    1. Claerhout I, Goegebuer A, Van Den Broecke C, et al. Delay in diagnosis and outcome of Acanthamoeba keratitis. Graefes Arch Clin Exp Ophthalmol. 2004;242(8):648‐653.
    1. Ikeda Y, Miyazaki D, Yakura K, et al. Assessment of real‐time polymerase chain reaction detection of Acanthamoeba and prognosis determinants of Acanthamoeba keratitis. Ophthalmology. 2012;119(6):1111‐1119.
    1. Goh JWY, Harrison R, Hau S, Alexander CL, Tole DM, Avadhanam VS. Comparison of in vivo confocal microscopy, PCR and culture of corneal scrapes in the diagnosis of Acanthamoeba keratitis. Cornea. 2018;37(4):480‐485.
    1. Lorenzo‐Morales J, Khan NA, Walochnik J. An update on Acanthamoeba keratitis: diagnosis, pathogenesis and treatment. Parasite. 2015;22:10.
    1. Roberts CW, Henriquez FL. Drug target identification, validation, characterisation and exploitation for treatment of Acanthamoeba (species) infections. Exp Parasitol. 2010;126(1):91‐96.
    1. Dart JK, Saw VP, Kilvington S. Acanthamoeba keratitis: diagnosis and treatment update 2009. Am J Ophthalmol. 2009;148(4):487‐99.e2.
    1. Robaei D, Carnt N, Minassian DC, Dart JKG. Therapeutic and optical keratoplasty in the management of Acanthamoeba keratitis: risk factors, outcomes, and summary of the literature. Ophthalmology. 2015;122(1):17‐24.
    1. Cohen EJ, Parlato CJ, Arentsen JJ, et al. Medical and surgical treatment of Acanthamoeba keratitis. Am J Ophthalmol. 1987;103(5):615‐625.
    1. Carnt N, Robaei D, Watson SL, Minassian DC, Dart JKG. The impact of topical corticosteroids used in conjunction with Antiamoebic therapy on the outcome of Acanthamoeba keratitis. Ophthalmology. 2016;123(5):984‐990.
    1. Carnt N, Stapleton F. Strategies for the prevention of contact lens‐related Acanthamoeba keratitis: a review. Ophthalmic Physiol Opt. 2016;36(2):77‐92.

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅