Diagnosis of Acanthamoeba Keratitis: Past, Present and Future

Matthew Azzopardi, Yu Jeat Chong*, Benjamin Ng, Alberto Recchioni, Abison Logeswaran, Darren S. J. Ting*, Jae-Ho Han (Editor)

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Abstract

Acanthamoeba keratitis (AK) is a painful and sight-threatening parasitic corneal infection. In recent years, the incidence of AK has increased. Timely and accurate diagnosis is crucial during the management of AK, as delayed diagnosis often results in poor clinical outcomes. Currently, AK diagnosis is primarily achieved through a combination of clinical suspicion, microbiological investigations and corneal imaging. Historically, corneal scraping for microbiological culture has been considered to be the gold standard. Despite its technical ease, accessibility and cost-effectiveness, the long diagnostic turnaround time and variably low sensitivity of microbiological culture limit its use as a sole diagnostic test for AK in clinical practice. In this review, we aim to provide a comprehensive overview of the diagnostic modalities that are currently used to diagnose AK, including microscopy with staining, culture, corneal biopsy, in vivo confocal microscopy, polymerase chain reaction and anterior segment optical coherence tomography. We also highlight emerging techniques, such as next-generation sequencing and artificial intelligence-assisted models, which have the potential to transform the diagnostic landscape of AK.
Original languageEnglish
Article number2655
Number of pages20
JournalDiagnostics
Volume13
Issue number16
Early online date11 Aug 2023
DOIs
Publication statusE-pub ahead of print - 11 Aug 2023

Keywords

  • in vivo confocal microscopy
  • next-generation sequencing
  • artificial intelligence
  • culture and microscopy
  • diagnosis
  • Acanthamoeba keratitis
  • anterior segment optical coherence tomography
  • polymerase chain reaction
  • corneal biopsy

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