The Natural History of Acanthamoeba Keratitis: A Systematic Literature Review.

IF 2.6 3区 医学 Q2 OPHTHALMOLOGY
Vincenzo Papa, Danielle H Bodicoat, Angela Arteaga Duarte, John K G Dart, Maria De Francesco
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引用次数: 0

Abstract

Introduction: Acanthamoeba keratitis (AK) was first identified in 1972 and the first patient cured with propamidine was reported in 1985. Treatment outcomes, before the advent of the first effective anti-amoebic treatment, were known to be poor and often required therapeutic keratoplasty (TK) but have not been evaluated in detail. Analysis of these outcomes has value for several reasons: it gives an historical perspective, describes the natural history of AK when the disease was minimally modified by the early treatments and provides a benchmark against which current treatments can be compared and how these have changed the therapeutic results.

Methods: We conducted a systematic literature review for the period 1970-1995 using PRISMA guidelines. The population of interest comprised patients with AK treated without products having established anti-amoebic activity against both trophozoites and cysts (biguanides or diamidines). The outcomes of interest were medical cure, TK and enucleation. Proportions and 95% confidence intervals were estimated.

Results: Fifty-six case reports were eligible. Risk factors for AK were reported in 44/56 patients: contact lens wear in 30/44 (68.2%) and trauma in 14/44 (31.8%). The mean time from presentation to diagnosis was 7.3 weeks (standard deviation 9.3 weeks); 13/56 (23.2%) were diagnosed within 4 weeks. Topical treatments given to patients included corticosteroids (85.2%), antibiotics (85.2%), antivirals (72.2%) and antifungals (51.8%). Final visual acuity was ≥ 20/40 in 17/33 (51.5%) patients with no missing data. Medical cures were reported in 11/56 patients (19.6%), TK in 38/56 (67.9%), other surgery in 4/56 (7.1%) and enucleation in 3/56 (5.4%).

Conclusion: This study suggests that, before the availability of propamidine as the first effective treatment for AK, the clinical outcome of these patients was poor with only a few patients cured without surgery. These findings should be interpreted with caution because they rely on case reports and series that are subject to inherent bias.

棘阿米巴角膜炎的自然历史:系统文献综述。
棘阿米巴角膜炎(AK)于1972年首次被发现,1985年报道了第一例用丙脒治愈的患者。在第一种有效的抗阿米巴治疗方法出现之前,治疗结果已知很差,通常需要治疗性角膜移植术(TK),但尚未进行详细评估。对这些结果的分析有几个原因:它提供了一个历史视角,描述了早期治疗对AK疾病的最低限度改变时的自然历史,并提供了一个基准,可以与当前的治疗进行比较,以及这些治疗如何改变了治疗结果。方法:我们采用PRISMA指南对1970-1995年间的文献进行了系统回顾。感兴趣的人群包括接受AK治疗的患者,这些患者没有对滋养体和囊肿(双胍类或二胺类)具有抗阿米巴活性的产品。关注的结果是医学治愈、TK和去核。估计了比例和95%置信区间。结果:56例报告符合条件。56例患者中有44例报告了AK的危险因素:佩戴隐形眼镜30例(68.2%),外伤14例(31.8%)。从首发到诊断的平均时间为7.3周(标准差为9.3周);13/56(23.2%)在4周内确诊。给予患者的局部治疗包括皮质类固醇(85.2%)、抗生素(85.2%)、抗病毒药物(72.2%)和抗真菌药物(51.8%)。17/33(51.5%)患者的最终视力≥20/40,无数据缺失。内科治愈11/56例(19.6%),TK 38/56例(67.9%),其他手术4/56例(7.1%),摘除3/56例(5.4%)。结论:本研究提示,在丙脒作为治疗AK的第一有效药物之前,这些患者的临床预后较差,只有少数患者无需手术治愈。这些发现应谨慎解释,因为它们依赖于受固有偏见影响的病例报告和系列。
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来源期刊
Ophthalmology and Therapy
Ophthalmology and Therapy OPHTHALMOLOGY-
CiteScore
4.20
自引率
3.00%
发文量
157
审稿时长
6 weeks
期刊介绍: Aims and Scope Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. Rapid Publication The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of ophthalmic therapies. Open Access All articles published by Ophthalmology and Therapy are open access. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning authors will always have an editorial contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. Digital Features and Plain Language Summaries Ophthalmology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’. For examples of digital features please visit our showcase page https://springerhealthcare.com/expertise/publishing-digital-features/ Publication Fees Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of €5250/$6000/£4300. The journal will consider fee discounts and waivers for developing countries and this is decided on a case by case basis. Peer Review Process Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria. At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials, and Letters which are generally reviewed by one member of the Editorial Board. Where reviewer recommendations are conflicted, the editorial board will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed). Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case-by-case basis and should be sent to the journal editor. Preprints We encourage posting of preprints of primary research manuscripts on preprint servers, authors’ or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals. Authors should disclose details of preprint posting during the submission process or at any other point during consideration in one of our journals. Once the manuscript is published, it is the author’s responsibility to ensure that the preprint record is updated with a publication reference, including the DOI and a URL link to the published version of the article on the journal website. Please follow the link for further information on preprint sharing: https://www.springer.com/gp/authors-editors/journal-author/journal-author-helpdesk/submission/1302#c16721550 Copyright Ophthalmology and Therapy''s content is published open access under the Creative Commons Attribution-Noncommercial License, which allows users to read, copy, distribute, and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited. The author assigns the exclusive right to any commercial use of the article to Springer. For more information about the Creative Commons Attribution-Noncommercial License, click here: http://creativecommons.org/licenses/by-nc/4.0. Contact For more information about the journal, including pre-submission enquiries, please contact christopher.vautrinot@springer.com.
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