{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T01:35:34Z","timestamp":1772501734402,"version":"3.50.1"},"reference-count":84,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T00:00:00Z","timestamp":1698883200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ophthalmic Physiologic Optic"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Acanthamoeba<\/jats:italic>\n                      keratitis (AK) is a serious and potentially blinding ocular infection caused by the free\u2010living amoeba,\n                      <jats:italic>Acanthamoeba<\/jats:italic>\n                      . In\u00a0vivo confocal microscopy (IVCM) is a non\u2010invasive device which has been proven of great use to diagnose\n                      <jats:italic>Acanthamoeba<\/jats:italic>\n                      infections immediately. The aim of this review was to establish different patterns and signs of AK that appear on the IVCM both before and after treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review of the literature from 1974 until September 2021 was performed using Embase and PubMed, following The Preferred Reporting Items for Systematic reviews and Meta\u2010Analyses (PRISMA) guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty different signs of AK were observed using IVCM. The included studies used vastly different criteria to diagnose infections, ranging from just 1 to 13 of the signs, demonstrating the current lack of a standardised diagnosis of this infection using the IVCM. The appearance of double wall cysts, trophozoites, signet rings, target signs and clusters were shown to be pathognomonic to AK infections. Bright spots located in the corneal epithelium were demonstrated as non\u2010reliable predictors of AK. The presence of cysts in clusters and single file can predict the need for corneal transplantation. The morphological changes in cysts using the IVCM following treatment were described as breaking down to hollow forms and occasionally surrounded by black cavities. Using this information, a visual guideline for identifying AK signs in diagnosis and follow\u2010up using IVCM was created.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Increased awareness of the different signs and patterns of AK that appear on the IVCM is crucial in order to correctly identify an infection and increase the potential of this device. Our guidelines presented here can be used, but further studies are needed in order to determine the relationship and aetiology of these signs and cellular changes on the IVCM both before and after anti\u2010amoeba treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/opo.13238","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T09:32:10Z","timestamp":1698917530000},"page":"131-152","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Diagnosing and monitoring the characteristics of\n                    <i>Acanthamoeba<\/i>\n                    keratitis using slit scanning and laser scanning in\u00a0vivo confocal microscopy"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2888-7497","authenticated-orcid":false,"given":"K.","family":"Curro\u2010Tafili","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Amsterdam UMC, Vrije Universiteit Amsterdam  Amsterdam the Netherlands"},{"name":"Amsterdam Public Health Research Institute Quality of Care  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. 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