Resolution of Acanthamoeba Keratitis with Adjunctive Use of Oral Miltefosine

Document Type

Letter to the Editor

Publication Title

Ocular Immunology and Inflammation

Abstract

Purpose: To report a series of cases demonstrating the resolution of Acanthamoeba keratitis (AK) with adjunctive use of oral miltefosine.

Methods: Retrospective case series.

Results: The first case was a 27-year-old female who presented with severe pain and photophobia. The diagnosis of AK was made with confocal microscopy, which revealed a significant burden of stromal cysts. After approximately 2 weeks of adjunctive oral miltefosine therapy, there was a severe inflammatory response within the cornea followed by quick resolution of the AK. The second case was a 31-year-old male in whom the diagnosis of AK was confirmed by culture and polymerase chain reaction. Adjunctive oral miltefosine was started 3 months after presentation, leading to a quick resolution.

Conclusions: Oral miltefosine may have cysticidal properties and should be considered as adjunctive therapy for the treatment of AK, particularly in cases with a significant burden of cysts or in cases recalcitrant to other treatments.

DOI

10.1080/09273948.2019.1695853

Publication Date

2-17-2021

Keywords

Acanthamoeba keratitis, confocal microscopy, contact lens use, infectious keratitis, miltefosine

ISSN

1744-5078

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