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Open AccessArticle

Effectiveness and Safety of Topical Chlorhexidine and Vitamin E TPGS in the Treatment of Acanthamoeba Keratitis: A Survey on 29 Cases

1
Corneal Transplant Centre, Pellegrini Hospital, 80134 Naples, Italy
2
Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy
3
Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
4
Department of Ophthalmology, Salerno University Hospital, 84131 Salerno, Italy
5
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
6
Department of Medicine and Health Science, “V. Tiberio”, University of Molise, 86100 Campobasso, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(11), 3775; https://doi.org/10.3390/jcm9113775
Received: 9 September 2020 / Revised: 16 November 2020 / Accepted: 20 November 2020 / Published: 23 November 2020
(This article belongs to the Section Ophthalmology)
This study aimed to test the effectiveness of a solution of chlorhexidine (CHX) and D-α-tocopheryl polyethylene glycol succinate (Vitamin E TPGS or TPGS) in the treatment of Acanthamoeba keratitis (AK) via a prospective, interventional case series study. Twenty-nine consecutive patients with AK were enrolled. At baseline, best-corrected visual acuity (BCVA), slit lamp examination, confocal microscopy, and polymerase chain reaction (PCR) were performed. Topical therapy with CHX 0.02% and VE-TPGS 0.2% was administered hourly/24 h for the first day, hourly in the daytime for the next three days, and finally, every two hours in the daytime up to one month. BCVA and ocular inflammation were recorded after two weeks, four weeks, and three months from baseline. Mean logMAR BCVA significantly improved at two weeks (0.78) compared to baseline (1.76), remaining stable over time (0.80 at four weeks, 0.77 at three months). Ocular inflammation improved in 14 eyes at 2 weeks, with further slow improvements in all cases. At three months, no patient had signs of corneal inflammation. The presence of corneal scars was first recorded at the two-week follow-up, with an enlargement at the four-week follow-up. At the three-month follow-up, 19 eyes still showed corneal opacities. In conclusion, the tested solution was shown to be effective for the treatment of AK. Furthermore, it might represent a good first-line treatment. View Full-Text
Keywords: Acanthamoeba keratitis; chlorhexidine; vitamin E TPGS; ocular infections; drug delivery systems Acanthamoeba keratitis; chlorhexidine; vitamin E TPGS; ocular infections; drug delivery systems
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MDPI and ACS Style

Caruso, C.; Eletto, D.; Rinaldi, M.; Pacente, L.; Troisi, S.; Semeraro, F.; dell’Omo, R.; Costagliola, C. Effectiveness and Safety of Topical Chlorhexidine and Vitamin E TPGS in the Treatment of Acanthamoeba Keratitis: A Survey on 29 Cases. J. Clin. Med. 2020, 9, 3775.

AMA Style

Caruso C, Eletto D, Rinaldi M, Pacente L, Troisi S, Semeraro F, dell’Omo R, Costagliola C. Effectiveness and Safety of Topical Chlorhexidine and Vitamin E TPGS in the Treatment of Acanthamoeba Keratitis: A Survey on 29 Cases. Journal of Clinical Medicine. 2020; 9(11):3775.

Chicago/Turabian Style

Caruso, Ciro; Eletto, Daniela; Rinaldi, Michele; Pacente, Luigi; Troisi, Salvatore; Semeraro, Francesco; dell’Omo, Roberto; Costagliola, Ciro. 2020. "Effectiveness and Safety of Topical Chlorhexidine and Vitamin E TPGS in the Treatment of Acanthamoeba Keratitis: A Survey on 29 Cases" J. Clin. Med. 9, no. 11: 3775.

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