Acanthamoeba in the eye, can the parasite hide even more? Latest developments on the disease

JUÁREZ, M.M.; TÁRTARA, L.I.; CID, A.G.; REAL, J.P.; BERMÚDEZ, J.M.; RAJAL, V.B.; PALMA, S.D.

Contact Lens and Anterior Eye

Elsevier

Año: 2018 vol. 41 p. 245 - 251

1367-0484

Acanthamoeba spp. is a protozoan that has free life in the environment, but can cause serious diseases. Acanthamoeba keratitis (AK), a severe and painful eye infection, must be treated as soon as possible to prevent ulceration of the cornea, loss of visual acuity, and eventually blindness or enucleation. Although the disease affects principally contact lens (CLs) wearers, it is recognized nowadays as an important cause of keratitis also in non-CLs wearers. Even if the number of infections caused by these amoebae is low, AK is becoming an emerging disease presenting an increased number of cases each year worldwide mostly due to the extended use of CLs, but also to better diagnostic methods and awareness.There are two principal causes responsible of not stopping on time the ocular damage: misdiagnosis or late diagnosis of the causal agent, and lack of a fully effective therapy due to the existence of a highly resistant cyst stage of Acanthamoeba.Recent studies have reported more virulent genotypes never found before in this type of injury. In addition, Acanthamoeba can act as a reservoir for phylogenetically diverse microorganisms. In this regard, recently giant viruses called Pandoravirus have been found within genotypes producing keratitis. If they could represent a potential risk to humanity is a controversial question that has not yet been solved.This review focuses on an overview of the present status and future prospects of this re-emerging pathology, including features of the parasite, epidemiology, clinical aspects, diagnosis, and treatment.