Practice patterns and opinions in the treatment of acanthamoeba keratitis.
Practice patterns and opinions in the treatment of acanthamoeba keratitis.
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DOI：
10.1097/ico.0b013e31820f7763
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发表时间：
2011-12
期刊：
影响因子：
2.8
通讯作者：
Keenan JD
中科院分区：
文献类型：
--
作者：
Oldenburg CE;Acharya NR;Tu EY;Zegans ME;Mannis MJ;Gaynor BD;Whitcher JP;Lietman TM;Keenan JD
棘阿米巴角膜炎的管理仍然是眼科医生的挑战。我们对角膜协会的成员进行了调查，以征求专家对棘阿米巴角膜炎的诊断和治疗的意见。一份在线调查被发送给角膜协会kera-net列表服务的所有订阅者。进行描述性统计。82名参与者完成了在线调查。在82名受访者中，76.8%的人将临床检查和培养结合起来作为诊断策略，43.9%的人使用共聚焦显微镜。大多数应答者（97.6%）在过去的某个时间点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%）曾使用单一治疗。受访者最常选择PHMB作为单药治疗的理想选择（51.4%），双胍和二胺双药治疗是联合治疗的理想选择（37.5%）。大多数应答者（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。大多数受访者（75.6%）认为角膜移植是一种选择，尽管大多数受访者（85.5%）只会在药物治疗失败后进行手术。棘阿米巴角膜炎的诊断和治疗目前有广泛的实践模式。由于缺乏足够有力的比较有效性研究和临床试验，因此很难对这种疾病进行循证决策。
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 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 PHMB 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 evidenced-based decision making for this disease difficult.