A rare but extremely disabling form of keratitis for which there are currently no authorised drugs, but scientific research is about to make a safe and effective therapy available.
A rare ocular infection with potentially very serious consequences, Acanthamoeba keratitis owes its name to a ubiquitous protozoan found in soil and water. For this inflammatory pathology of the cornea, often associated with the prolonged use of contact lenses (85% of cases) and their poor hygiene, the absence of specific therapies will soon be remedied, as you can discover by listening to the fifth episode of 'Ascolta e vedrai', the L'Oculista Italiano podcast to promote and support the wellbeing of eyesight and learn how to know and protect our eyes.
Set, given the season, on the seashore, the podcast on Acanthamoeba keratitis not only identifies the unspecific symptoms of the disorder - pain, redness, blurred vision, hypersensitivity to light and excessive tearing - but also provides important indications for an early and correct diagnosis, useful to avoid the devastating effects on quality of life due to intense pain and possible vision damage, such as corneal perforation.
Acanthamoeba keratitis, which affects about 2 in 100,000 people, is not the only rare eye disease. So far, a total of between 5 and 8 thousand rare eye diseases have been recognised, most of which have a genetic origin and can affect vision, either directly or as a consequence of systemic diseases that, for example, affect the nervous system.
Therapy for Acanthamoeba keratitis must be based on drugs that suppress the protozoan in both the active and cystic phases.
At present, there is no authorised drug treatment for Acanthamoeba keratitis in any country in the world, which is treated with 'off-label' topical therapies, i.e. administered under the direct responsibility of the physician.
As is explained in a simple and straightforward manner in the podcast, topical therapy can be effective, but must be started early, as the course is complex and lasts up to 6-12 months. Early surgical procedures should be carefully considered as they may reduce the risk of corneal perforation and endothelial damage, but increase the rate of recurrence of infection, compared to a delayed intervention performed after eradication of Acanthamoeba through pharmacological treatment. Corneal transplantation may be necessary in many cases.
As reiterated in the podcast, there is currently no authorised drug in any country for the treatment of Acanthamoeba keratitis, but the first drug for ophthalmic use, based on polyhexanide (PHMB), indicated precisely for this disease, has recently completed clinical development after 15 years of research. The drug - recognised as an 'Orphan Drug' (i.e. dedicated to the treatment of an 'orphan disease' - a rare disease with no authorised therapies) by the European Medicines Agency (Ema) - has been developed in a high-dose formulation of 0.08%, to be used as monotherapy, in a single-dose format with no preservatives, thus better tolerated by the ocular surface, and effective against Acanthamoeba, both in the cystic phase and against the protozoan.
All the tips and updates to prevent and treat Acanthamoeba keratitis are contained in the episode published in 'Ascolta e vedrai' the podcast of the Italian Oculist, present on the platforms - Apple Podcasts, Google Podcasts, Spotify, Spreaker - and on www.oculistaitaliano.itwhere you can also find other insights and updates. The next episode will be dedicated to flying flies and vitreous degeneration.
To listen to all the podcasts already published, go to the dedicated section 'Listen and you will see'
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