{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:08:26Z","timestamp":1787062106869,"version":"build-2736575974"},"reference-count":151,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T00:00:00Z","timestamp":1712620800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Acanthamoeba keratitis (AK) is a rare but potentially sight-threatening corneal infection caused by the Acanthamoeba parasite. This microorganism is found ubiquitously in the environment, often in freshwater, soil, and other sources of moisture. Despite its low incidence, AK presents significant challenges due to delayed diagnosis and the complex nature of therapeutic management. Early recognition is crucial to prevent severe ocular complications, including corneal ulceration and vision loss. Diagnostic modalities and treatment strategies may vary greatly depending on the clinical manifestation and the available tools. With the growing reported cases of Acanthamoeba keratitis, it is essential for the ophthalmic community to thoroughly understand this condition for its effective management and improved outcomes. This review provides a comprehensive overview of AK, encompassing its epidemiology, risk factors, pathophysiology, clinical manifestations, diagnosis, and treatment.<\/jats:p>","DOI":"10.3390\/microorganisms12040758","type":"journal-article","created":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T08:55:12Z","timestamp":1712652912000},"page":"758","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Understanding Acanthamoeba Keratitis: An In-Depth Review of a Sight-Threatening Eye Infection"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0446-2846","authenticated-orcid":false,"given":"Francesco","family":"Petrillo","sequence":"first","affiliation":[{"name":"Department of Surgical Sciences, University of Turin, 10126 Turin, Italy"},{"name":"Department of Ophthalmology, \u201cCity of Health and Science\u201d Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1151-8732","authenticated-orcid":false,"given":"Antonia","family":"Tortori","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Surgery Department, Piacenza Hospital, 29121 Piacenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Vallino","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, University of Turin, 10126 Turin, Italy"},{"name":"Department of Ophthalmology, \u201cCity of Health and Science\u201d Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilena","family":"Galdiero","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, 81100 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio M.","family":"Fea","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, University of Turin, 10126 Turin, Italy"},{"name":"Department of Ophthalmology, \u201cCity of Health and Science\u201d Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugo","family":"De Sanctis","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, University of Turin, 10126 Turin, Italy"},{"name":"Department of Ophthalmology, \u201cCity of Health and Science\u201d Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1368-6729","authenticated-orcid":false,"given":"Michele","family":"Reibaldi","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, University of Turin, 10126 Turin, Italy"},{"name":"Department of Ophthalmology, \u201cCity of Health and Science\u201d Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1111\/ceo.14113","article-title":"Infectious keratitis: A review","volume":"50","author":"Khoo","year":"2022","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1038\/s41433-020-01339-3","article-title":"Infectious keratitis: An update on epidemiology, causative microorganisms, risk factors, and antimicrobial resistance","volume":"35","author":"Ting","year":"2021","journal-title":"Eye"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Petrillo, F., Petrillo, A., Sasso, F.P., Schettino, A., Maione, A., and Galdiero, M. (2022). Viral Infection and Antiviral Treatments in Ocular Pathologies. Microorganisms, 10.","DOI":"10.3390\/microorganisms10112224"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Petrillo, F., Sinoca, M., Fea, A.M., Galdiero, M., Maione, A., Galdiero, E., Guida, M., and Reibaldi, M. (2023). Candida Biofilm Eye Infection: Main Aspects and Advance in Novel Agents as Potential Source of Treatment. Antibiotics, 12.","DOI":"10.3390\/antibiotics12081277"},{"key":"ref_5","unstructured":"JKrachmer, H., Mannis, M.J., and Holland, E.J. (2011). Surgery of the Cornea and Conjunctiva, Mosby Elsevier. [3rd ed.]."},{"key":"ref_6","first-page":"210","article-title":"Recurrent suppurative kerato-uveitis with loss of eye due to infection by Acanthamoeba castellani","volume":"95","author":"Jones","year":"1975","journal-title":"Trans. Ophthalmol. Soc. UK"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/j.jiph.2023.03.020","article-title":"The global epidemiology and clinical diagnosis of Acanthamoeba keratitis","volume":"16","author":"Zhang","year":"2023","journal-title":"J. Infect. Public Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.3201\/eid1508.090225","article-title":"National outbreak of Acanthamoeba keratitis associated with use of a contact lens solution, United States","volume":"15","author":"Verani","year":"2009","journal-title":"Emerg. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.ajo.2006.04.034","article-title":"Epidemiological Characteristics of a Chicago-area Acanthamoeba Keratitis Outbreak","volume":"142","author":"Joslin","year":"2006","journal-title":"Am. J. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1016\/j.ophtha.2011.12.041","article-title":"Characteristics of an Acanthamoeba Keratitis Outbreak in British Columbia between 2003 and 2007","volume":"119","author":"Fraser","year":"2012","journal-title":"Ophthalmology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1136\/bjo.82.12.1387","article-title":"Acanthamoeba keratitis: Multicentre survey in England 1992-6","volume":"82","author":"Radford","year":"1998","journal-title":"Br. J. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/S1367-0484(99)80003-4","article-title":"Population-based cohort study of microbial keratitis in Scotland: Incidence and features","volume":"22","author":"Seal","year":"1999","journal-title":"Contact Lens Anterior Eye"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1136\/bjo.86.5.536","article-title":"Acanthamoeba keratitis in England and Wales: Incidence, outcome, and risk factors","volume":"86","author":"Radford","year":"2002","journal-title":"Br. J. Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/j.clae.2019.04.009","article-title":"Analysis from a year of increased cases of Acanthamoeba Keratitis in a large teaching hospital in the UK","volume":"42","author":"Hassan","year":"2019","journal-title":"Contact Lens Anterior Eye"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Randag, A.C., Van Rooij, J., Van Goor, A.T., Verkerk, S., Wisse, R.P.L., Saelens, I.E.Y., Stoutenbeek, R., Van Dooren, B.T.H., Cheng, Y.Y.Y., and Eggink, C.A. (2019). The rising incidence of Acanthamoeba keratitis: A 7-year nationwide survey and clinical assessment of risk factors and functional outcomes. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0222092"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1111\/aos.14337","article-title":"Increasing incidence of Acanthamoeba keratitis in a large tertiary ophthalmology department from year 1994 to 2018","volume":"98","author":"Nielsen","year":"2020","journal-title":"Acta Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1136\/bjophthalmol-2017-310428","article-title":"Risk factors, demographics and clinical profile of Acanthamoeba keratitis in Melbourne: An 18-year retrospective study","volume":"102","author":"Lee","year":"2018","journal-title":"Br. J. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1111\/j.1442-9071.2008.01910.x","article-title":"Acanthamoeba keratitis cluster: An increase in Acanthamoeba keratitis in Australia","volume":"37","author":"Ku","year":"2009","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"111","DOI":"10.3109\/09286586.2011.645990","article-title":"Acanthamoeba Keratitis in South India: A Longitudinal Analysis of Epidemics","volume":"19","author":"Lalitha","year":"2012","journal-title":"Ophthalmic Epidemiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ajo.2009.02.030","article-title":"Acanthamoeba Keratitis Associated with Contact Lens Wear in Singapore","volume":"148","author":"Por","year":"2009","journal-title":"Am. J. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1136\/bjophthalmol-2013-303386","article-title":"Acanthamoeba keratitis: Study of the 5-year incidence in Israel: Table 1","volume":"97","author":"Graffi","year":"2013","journal-title":"Br. J. Ophthalmol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.ajo.2007.09.037","article-title":"Bilateral Acanthamoeba Keratitis","volume":"145","author":"Wilhelmus","year":"2008","journal-title":"Am. J. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Varacalli, G., Di Zazzo, A., Mori, T., Dohlman, T.H., Spelta, S., Coassin, M., and Bonini, S. (2021). Challenges in Acanthamoeba Keratitis: A Review. J. Clin. Med., 10.","DOI":"10.3390\/jcm10050942"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2301","DOI":"10.1016\/j.ophtha.2008.06.034","article-title":"Safety of Overnight Orthokeratology for Myopia","volume":"115","author":"Musch","year":"2008","journal-title":"Ophthalmology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1136\/bjo.79.12.1078","article-title":"Acanthamoeba keratitis: Risk factors and outcome","volume":"79","author":"Illingworth","year":"1995","journal-title":"Br. J. Ophthalmol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"221","DOI":"10.3109\/09286586.2012.681336","article-title":"Acanthamoeba keratitis: The Persistence of Cases Following a Multistate Outbreak","volume":"19","author":"Yoder","year":"2012","journal-title":"Ophthalmic Epidemiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"37","DOI":"10.4103\/0301-4738.29493","article-title":"A study of the spectrum of Acanthamoeba keratitis: A three-year study at a tertiary eye care referral center in South India","volume":"55","author":"Bharathi","year":"2007","journal-title":"Indian J. Ophthalmol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.jtos.2015.01.002","article-title":"Acanthamoeba Keratitis: Clinical Characteristics and Management","volume":"13","author":"Jiang","year":"2015","journal-title":"Ocul. Surf."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S0035-9203(01)90180-4","article-title":"Microbial keratitis in Hong Kong: Relationship to climate, environment and contact-lens disinfection","volume":"95","author":"Houang","year":"2001","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1097\/01.icl.0000252567.06446.7b","article-title":"Bilateral Acanthamoeba Keratitis in an Experienced Two-Weekly Disposable Contact Lens Wearer","volume":"33","author":"Voyatzis","year":"2007","journal-title":"Eye Contact Lens Sci. Clin. Pract."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"108365","DOI":"10.1016\/j.exer.2020.108365","article-title":"The biology of Acanthamoeba keratitis","volume":"202","author":"Niederkorn","year":"2021","journal-title":"Exp. Eye Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1051\/parasite\/2015010","article-title":"An update on Acanthamoeba keratitis: Diagnosis, pathogenesis and treatment","volume":"22","author":"Khan","year":"2015","journal-title":"Parasite"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1002\/dc.25078","article-title":"Acanthamoeba keratitis","volume":"51","author":"Desai","year":"2023","journal-title":"Diagn. Cytopathol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Reyes-Batlle, M., Sifaoui, I., Rodr\u00edguez-Exp\u00f3sito, R.L., Pi\u00f1ero, J.E., and Lorenzo-Morales, J. (2022). New Insights in Acanthamoeba. Pathogens, 11.","DOI":"10.3390\/pathogens11050609"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3051","DOI":"10.1007\/s00436-021-07261-1","article-title":"Genotype distribution of Acanthamoeba in keratitis: A systematic review","volume":"120","author":"Diehl","year":"2021","journal-title":"Parasitol. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.exppara.2016.02.012","article-title":"Acanthamoeba infection in lungs of mice expressed by toll-like receptors (TLR2 and TLR4)","volume":"165","author":"Derda","year":"2016","journal-title":"Exp. Parasitol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/jeu.12186","article-title":"Phylogenetic Analysis and the Evolution of the 18S rRNA Gene Typing System of Acanthamoeba","volume":"62","author":"Fuerst","year":"2015","journal-title":"J. Eukaryot. Microbiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"147","DOI":"10.4067\/S0716-10182013000200005","article-title":"Acanthamoeba spp. como par\u00e1sitos pat\u00f3genos y oportunistas","volume":"30","author":"Orozco","year":"2013","journal-title":"Rev. Chil. Infectol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1111\/j.1574-6976.2006.00023.x","article-title":"Acanthamoeba: Biology and increasing importance in human health","volume":"30","author":"Khan","year":"2006","journal-title":"FEMS Microbiol. Rev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jiph.2017.09.013","article-title":"Acanthamoeba keratitis in noncompliant soft contact lenses users: Genotyping and risk factors, a study from Cairo, Egypt","volume":"11","author":"Taher","year":"2018","journal-title":"J. Infect. Public Health"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1001\/archopht.1990.01070030113040","article-title":"Pathogenicity of Acanthamoeba and a Corynebacterium in the Rat Cornea","volume":"108","author":"Badenoch","year":"1990","journal-title":"Arch. Ophthalmol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1128\/IAI.73.2.1061-1068.2005","article-title":"Role of Contact Lens Wear, Bacterial Flora, and Mannose-Induced Pathogenic Protease in the Pathogenesis of Amoebic Keratitis","volume":"73","author":"Alizadeh","year":"2005","journal-title":"Infect. Immun."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.ophtha.2009.08.033","article-title":"Detection of Bacterial Endosymbionts in Clinical Acanthamoeba Isolates","volume":"117","author":"Iovieno","year":"2010","journal-title":"Ophthalmology"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1111\/j.1574-6968.1998.tb13895.x","article-title":"Enhancement of in vitro cytopathogenicity by Acanthamoeba spp. following acquisition of bacterial endosymbionts","volume":"166","author":"Fritsche","year":"1998","journal-title":"FEMS Microbiol. Lett."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/S0002-9394(14)72126-9","article-title":"Acanthamoeba Endophthalmitis in Acquired Immunodeficiency Syndrome","volume":"122","author":"Heffler","year":"1996","journal-title":"Am. J. Ophthalmol."},{"key":"ref_46","first-page":"221","article-title":"Acanthamoeba polyphaga keratitis and Acenthamoeba uveitis associated with fatal meningoencephalitis","volume":"95","author":"Jones","year":"1975","journal-title":"Trans. Ophthalmol. Soc. UK"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2232","DOI":"10.1016\/S0161-6420(01)00765-5","article-title":"Chorioretinitis after keratitis caused by Acanthamoeba Case report and review of the literature","volume":"108","author":"Moshari","year":"2001","journal-title":"Ophthalmology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1111\/j.1550-7408.1998.tb05099.x","article-title":"The Interaction of Acanthamoeba spp. with Activated Macrophages and with Macrophage Cell Lines","volume":"45","author":"Toney","year":"1998","journal-title":"J Eukaryot. Microbiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"849","DOI":"10.2307\/3283316","article-title":"Chemotactic response of macrophages to Acanthamoeba castellanii antigen and antibody-dependent macrophage-mediated killing of the parasite","volume":"78","author":"Stewart","year":"1992","journal-title":"J. Parasitol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1645\/0022-3395(2003)089[0565:TIOACC]2.0.CO;2","article-title":"The Interaction of Acanthamoeba Castellanii Cysts with Macrophages and Neutrophils","volume":"89","author":"Hurt","year":"2003","journal-title":"J. Parasitol."},{"key":"ref_51","first-page":"477","article-title":"Activation of the alternative pathway of complement by Acanthamoeba culbertsoni","volume":"54","author":"Ferrante","year":"1983","journal-title":"Clin. Exp. Immunol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"338","DOI":"10.2307\/3284492","article-title":"Resistance of Acanthamoeba species to complement lysis","volume":"84","author":"Toney","year":"1998","journal-title":"J. Parasitol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1097\/00003226-200108000-00013","article-title":"Tear IgA and Serum IgG Antibodies Against Acanthamoeba in Patients with Acanthamoeba Keratitis","volume":"20","author":"Alizadeh","year":"2001","journal-title":"Cornea"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1128\/iai.29.2.401-407.1980","article-title":"Immunity to pathogenic free-living amoebae: Role of humoral antibody","volume":"29","author":"Cursons","year":"1980","journal-title":"Infect. Immun."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1007\/BF00933001","article-title":"Acanthamoeba-specific human T-cell clones isolated from healthy individuals","volume":"80","author":"Tanaka","year":"1994","journal-title":"Parasitol. Res."},{"key":"ref_56","first-page":"2885","article-title":"Effect of steroids on Acanthamoeba cysts and trophozoites","volume":"42","author":"McClellan","year":"2001","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/j.ophtha.2016.01.020","article-title":"The Impact of Topical Corticosteroids Used in Conjunction with Antiamoebic Therapy on the Outcome of Acanthamoeba Keratitis","volume":"123","author":"Carnt","year":"2016","journal-title":"Ophthalmology"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1007\/s00347-014-3225-7","article-title":"Das Deutsche Akantham\u00f6benkeratitis-Register: Erste Ergebnisse einer multizentrischen Erhebung","volume":"112","author":"Daas","year":"2015","journal-title":"Ophthalmologe"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1038\/eye.1996.148","article-title":"Acanthamoeba keratitis: Masquerading as adenoviral keratitis","volume":"10","author":"Goodall","year":"1996","journal-title":"Eye"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1097\/00003226-200110000-00017","article-title":"Atypical Presentation of Acanthamoeba Keratitis","volume":"20","author":"Tabin","year":"2001","journal-title":"Cornea"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.pt.2013.01.006","article-title":"Acanthamoeba keratitis: An emerging disease gathering importance worldwide?","volume":"29","author":"Valladares","year":"2013","journal-title":"Trends Parasitol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/j.ajo.2009.06.009","article-title":"Acanthamoeba Keratitis: Diagnosis and Treatment Update 2009","volume":"148","author":"Dart","year":"2009","journal-title":"Am. J. Ophthalmol."},{"key":"ref_63","first-page":"CD010792","article-title":"Medical interventions for acanthamoeba keratitis","volume":"2015","author":"Alkharashi","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1055\/s-0031-1299539","article-title":"Die Akantham\u00f6benkeratitis\u2014Ein seltenes und oft sp\u00e4t diagnostiziertes Cham\u00e4leon","volume":"229","author":"Goebels","year":"2012","journal-title":"Klin. Monatsbl Augenheilkd."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1007\/s00417-003-0805-7","article-title":"Delay in diagnosis and outcome of Acanthamoeba keratitis","volume":"242","author":"Claerhout","year":"2004","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/ICL.0b013e31802b64c1","article-title":"Updates in Acanthamoeba Keratitis","volume":"33","author":"Awwad","year":"2007","journal-title":"Eye Contact Lens Sci. Clin. Pract."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1097\/OPX.0000000000001906","article-title":"Case Series: Unusual Presentation of Acanthamoeba Coinfection in the Cornea","volume":"99","author":"Chuang","year":"2022","journal-title":"Optom. Vis. Sci."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1998","DOI":"10.1016\/j.ophtha.2008.04.038","article-title":"Prognostic Factors Affecting Visual Outcome in Acanthamoeba Keratitis","volume":"115","author":"Tu","year":"2008","journal-title":"Ophthalmology"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1001\/archopht.1991.01080060030012","article-title":"Radial Keratoneuritis in Pseudomonas Keratitis","volume":"109","author":"Feist","year":"1991","journal-title":"Arch. Ophthalmol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1016\/S0161-6420(95)30830-5","article-title":"Decreased Corneal Sensation as an Initial Feature of Acanthamoeba Keratitis","volume":"102","author":"Perry","year":"1995","journal-title":"Ophthalmology"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1097\/01.icl.0000189039.68782.fe","article-title":"Secondary Glaucoma Associated with Advanced Acanthamoeba Keratitis","volume":"32","author":"Kelley","year":"2006","journal-title":"Eye Contact Lens Sci. Clin. Pract."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1038\/sj.eye.6702438","article-title":"Sterile corneal ulcer with ring infiltrate and hypopyon after recurrent erosions","volume":"21","author":"Papathanassiou","year":"2007","journal-title":"Eye"},{"key":"ref_73","first-page":"bcr0820103233","article-title":"Delayed diagnosis of microsporidial stromal keratitis: Unusual Wessely ring presentation and partial treatment with medications against Acanthamoeba","volume":"2011","author":"Thomas","year":"2011","journal-title":"Case Rep."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.ophtha.2006.07.038","article-title":"Severe Reactive Ischemic Posterior Segment Inflammation in Acanthamoeba Keratitis","volume":"114","author":"Awwad","year":"2007","journal-title":"Ophthalmology"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1016\/j.ophtha.2007.05.054","article-title":"Rapidly Progressive Cataract and Iris Atrophy during Treatment of Acanthamoeba Keratitis","volume":"115","author":"Herz","year":"2008","journal-title":"Ophthalmology"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1097\/ICO.0b013e31805b7e63","article-title":"Acanthamoeba Keratitis: A Parasite on the Rise","volume":"26","author":"Thebpatiphat","year":"2007","journal-title":"Cornea"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/0002-9394(85)90499-4","article-title":"Diagnosis and Management of Acanthamoeba Keratitis","volume":"100","author":"Cohen","year":"1985","journal-title":"Am. J. Ophthalmol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1159\/000309030","article-title":"Amoebic Keratitis","volume":"181","author":"Hamburg","year":"1980","journal-title":"Ophthalmologica"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/j.ophtha.2003.12.002","article-title":"Confocal microscopy","volume":"111","author":"Kaufman","year":"2004","journal-title":"Ophthalmology"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1136\/bjophthalmol-2020-316730","article-title":"PCR and culture for diagnosis of Acanthamoeba keratitis","volume":"105","author":"Yera","year":"2021","journal-title":"Br. J. Ophthalmol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.ophtha.2017.08.037","article-title":"Assessment of Confocal Microscopy for the Diagnosis of Polymerase Chain Reaction\u2013Positive Acanthamoeba Keratitis","volume":"125","author":"Knoeri","year":"2018","journal-title":"Ophthalmology"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"213","DOI":"10.3109\/02713683.2013.842592","article-title":"In Vivo Confocal Microscopy of the Ocular Surface: From Bench to Bedside","volume":"39","author":"Villani","year":"2014","journal-title":"Curr. Eye Res."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.survophthal.2016.09.005","article-title":"Ocular parasitoses: A comprehensive review","volume":"62","author":"Padhi","year":"2017","journal-title":"Surv. Ophthalmol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.4103\/ijo.IJO_826_17","article-title":"Non-contact lens related Acanthamoeba keratitis","volume":"65","author":"Garg","year":"2017","journal-title":"Indian. J. Ophthalmol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1097\/01.icu.0000233949.56229.7d","article-title":"Diagnosis and management of Acanthamoeba keratitis","volume":"17","author":"Hammersmith","year":"2006","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"2472","DOI":"10.1167\/iovs.05-0140","article-title":"Failure of Acanthamoeba castellanii to Produce Intraocular Infections","volume":"46","author":"Clarke","year":"2005","journal-title":"Invest. Ophthalmol. Vis. Sci."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/ICO.0b013e318218237e","article-title":"Ocular Surface Reconstruction after Exposure to High Concentrations of Antiseptic Solutions","volume":"31","author":"Shigeyasu","year":"2012","journal-title":"Cornea"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S0002-9394(14)70576-8","article-title":"Confocal Microscopy Findings of Acanthamoeba Keratitis","volume":"121","author":"Pfister","year":"1996","journal-title":"Am. J. Ophthalmol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1111\/j.1442-9071.2009.02128.x","article-title":"In vivo confocal microscopy in the diagnosis and management of acanthamoeba keratitis showing new cystic forms","volume":"37","author":"Alomar","year":"2009","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1016\/j.ophtha.2012.12.038","article-title":"In Vivo Laser Confocal Microscopy Findings of Radial Keratoneuritis in Patients with Early Stage Acanthamoeba Keratitis","volume":"120","author":"Kobayashi","year":"2013","journal-title":"Ophthalmology"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.ajo.2018.03.010","article-title":"In Vivo Confocal Microscopy Cellular Features of Host and Organism in Bacterial, Fungal, and A canthamoeba Keratitis","volume":"190","author":"Chidambaram","year":"2018","journal-title":"Am. J. Ophthalmol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1016\/S0161-6420(93)31457-0","article-title":"Clinical and Diagnostic Use of In Vivo Confocal Microscopy in Patients with Corneal Disease","volume":"100","author":"Cavanagh","year":"1993","journal-title":"Ophthalmology"},{"key":"ref_93","first-page":"1245","article-title":"Bowman\u2019s layer encystment in cases of persistent Acanthamoeba keratitis","volume":"6","author":"Yokogawa","year":"2012","journal-title":"Clin. Ophthalmol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.jtos.2021.11.003","article-title":"Diagnostic armamentarium of infectious keratitis: A comprehensive review","volume":"23","author":"Ting","year":"2022","journal-title":"Ocul. Surf."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1097\/00003226-200403000-00009","article-title":"Impact of Prior Therapy on the Recovery and Frequency of Corneal Pathogens","volume":"23","author":"Marangon","year":"2004","journal-title":"Cornea"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1167\/tvst.8.5.17","article-title":"In Vitro Evaluation of the Inhibitory Effect of Topical Ophthalmic Agents on Acanthamoeba Viability","volume":"8","author":"Heaselgrave","year":"2019","journal-title":"Trans. Vis. Sci. Technol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1001\/jamaophthalmol.2013.1644","article-title":"Effect of Low Concentrations of Benzalkonium Chloride on Acanthamoebal Survival and Its Potential Impact on Empirical Therapy of Infectious Keratitis","volume":"131","author":"Tu","year":"2013","journal-title":"JAMA Ophthalmol."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Fanselow, N., Sirajuddin, N., Yin, X.-T., Huang, A.J.W., and Stuart, P.M. (2021). Acanthamoeba Keratitis, Pathology, Diagnosis and Treatment. Pathogens, 10.","DOI":"10.3390\/pathogens10030323"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1097\/ICO.0000000000002337","article-title":"Acanthamoeba Keratitis Versus Mixed Acanthamoeba and Bacterial Keratitis: Comparison of Clinical and Microbiological Profiles","volume":"39","author":"Singh","year":"2020","journal-title":"Cornea"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.ajo.2019.01.024","article-title":"The Acanthamoeba\u2013Fungal Keratitis Study","volume":"201","author":"Raghavan","year":"2019","journal-title":"Am. J. Ophthalmol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"e000363","DOI":"10.1136\/bmjophth-2019-000363","article-title":"Does the sampling instrument influence corneal culture outcome in patients with infectious keratitis? A retrospective study comparing cotton tipped applicator with knife blade","volume":"5","author":"Sagerfors","year":"2020","journal-title":"BMJ Open Ophthalmol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1007\/s10792-018-0958-3","article-title":"Effectiveness of sampling methods employed for Acanthamoeba keratitis diagnosis by culture","volume":"39","author":"Rodrigo","year":"2019","journal-title":"Int. Ophthalmol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1128\/CMR.15.3.342-354.2002","article-title":"Cultivation of Pathogenic and Opportunistic Free-Living Amebas","volume":"15","author":"Schuster","year":"2002","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/S0161-6420(87)33516-X","article-title":"The Value of Calcofluor White in the Diagnosis of Mycotic and Acanthamoeba Infections of the Eye and Ocular Adnexa","volume":"94","author":"Marines","year":"1987","journal-title":"Ophthalmology"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/S0002-9394(03)00322-2","article-title":"Evaluation of hematoxylin and eosin and special stains for the detection of acanthamoeba keratitis in penetrating keratoplasties","volume":"136","author":"Grossniklaus","year":"2003","journal-title":"Am. J. Ophthalmol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s12348-023-00345-2","article-title":"The role of the calcofluor white staining in the diagnosis of Acanthamoeba keratitis","volume":"13","author":"Elhardt","year":"2023","journal-title":"J. Ophthal. Inflamm. Infect."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1136\/bjo.2006.096230","article-title":"Microbiological diagnosis of infective keratitis: Comparative evaluation of direct microscopy and culture results","volume":"90","author":"Bharathi","year":"2006","journal-title":"Br. J. Ophthalmol."},{"key":"ref_108","first-page":"152","article-title":"Polymerase Chain Reaction and Its Application in the Diagnosis of Infectious Keratitis","volume":"8","author":"Liu","year":"2019","journal-title":"Med. Hypothesis Discov. Innov. Ophthalmol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.survophthal.2018.12.003","article-title":"The persistent dilemma of microbial keratitis: Global burden, diagnosis, and antimicrobial resistance","volume":"64","author":"Ung","year":"2019","journal-title":"Surv. Ophthalmol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1097\/ICO.0000000000001497","article-title":"Comparison of In Vivo Confocal Microscopy, PCR and Culture of Corneal Scrapes in the Diagnosis of Acanthamoeba Keratitis","volume":"37","author":"Goh","year":"2018","journal-title":"Cornea"},{"key":"ref_111","first-page":"4148968","article-title":"The Value of Cytology Smears for Acanthamoeba Keratitis","volume":"2016","author":"Patel","year":"2016","journal-title":"Case Rep. Ophthalmol. Med."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1128\/JCM.40.5.1621-1625.2002","article-title":"18S Ribosomal DNA Typing and Tracking of Acanthamoeba Species Isolates from Corneal Scrape Specimens, Contact Lenses, Lens Cases, and Home Water Supplies of Acanthamoeba Keratitis Patients in Hong Kong","volume":"40","author":"Booton","year":"2002","journal-title":"J. Clin. Microbiol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1128\/JCM.39.5.1903-1911.2001","article-title":"Use of Subgenic 18S Ribosomal DNA PCR and Sequencing for Genus and Genotype Identification of Acanthamoebae from Humans with Keratitis and from Sewage Sludge","volume":"39","author":"Schroeder","year":"2001","journal-title":"J. Clin. Microbiol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/j.1550-7408.1998.tb05068.x","article-title":"The Evolutionary History of the Genus Acanthamoeba and the Identification of Eight New 18S rRNA Gene Sequence Types","volume":"45","author":"Stothard","year":"1998","journal-title":"J Eukaryot. Microbiol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s10096-007-0268-6","article-title":"Comparison of PCR, microscopic examination and culture for the early diagnosis and characterization of Acanthamoeba isolates from ocular infections","volume":"26","author":"Yera","year":"2007","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1080\/08164622.2021.1878857","article-title":"Bilateral Acanthamoeba keratitis with radial keratoneuritis\u2014Utility of AS-OCT in management and treatment","volume":"104","author":"Agarwal","year":"2021","journal-title":"Clin. Exp. Optom."},{"key":"ref_117","unstructured":"Lloreda Martin, L., Burgos-Blasco, B., and Matilla Rodero, M. (2021). AS-OCT and anterior segment negative image in the study of acanthamoeba keratitis. Arch. Soc. Esp. Oftalmol., online ahead of print."},{"key":"ref_118","first-page":"1416","article-title":"Comparison of anterior segment optical coherence tomography findings in acanthamoeba keratitis and herpetic epithelial keratitis","volume":"11","author":"Park","year":"2018","journal-title":"Int. J. Ophthalmol."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"2153","DOI":"10.1016\/j.ophtha.2014.04.043","article-title":"In Vivo Imaging of Radial Keratoneuritis in Patients with Acanthamoeba keratitis by Anterior-Segment Optical Coherence Tomography","volume":"121","author":"Yamazaki","year":"2014","journal-title":"Ophthalmology"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.ajo.2003.09.019","article-title":"Impression cytology in the diagnosis of acanthamoeba keratitis with surface involvement","volume":"137","author":"Sawada","year":"2004","journal-title":"Am. J. Ophthalmol."},{"key":"ref_121","first-page":"432","article-title":"Morphological characteristics in corneal smear of acanthamoeba keratitis","volume":"46","author":"Wang","year":"2010","journal-title":"Zhonghua Yan Ke Za Zhi"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1136\/bjophthalmol-2020-317848","article-title":"Safety and tolerability of topical polyhexamethylene biguanide: A randomised clinical trial in healthy adult volunteers","volume":"106","author":"Papa","year":"2022","journal-title":"Br. J. Ophthalmol."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.ajo.2007.08.040","article-title":"Comparison of Polyhexamethylene Biguanide and Chlorhexidine as Monotherapy Agents in the Treatment of Acanthamoeba Keratitis","volume":"145","author":"Lim","year":"2008","journal-title":"Am. J. Ophthalmol."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/00003226-199801000-00002","article-title":"Treatment of Acanthamoeba Keratitist","volume":"17","author":"Lindquist","year":"1998","journal-title":"Cornea"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1097\/ICO.0000000000000804","article-title":"Update on Acanthamoeba Keratitis: Diagnosis, Treatment, and Outcomes","volume":"35","author":"Maycock","year":"2016","journal-title":"Cornea"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1111\/ceo.13166","article-title":"The rising tide of Acanthamoeba keratitis in Auckland, New Zealand: A 7-year review of presentation, diagnosis and outcomes (2009\u20132016)","volume":"46","author":"McKelvie","year":"2018","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1016\/S0161-6420(99)00515-1","article-title":"Results of a trial of combined propamidine isethionate and neomycin therapy for acanthamoeba keratitis","volume":"106","author":"Hargrave","year":"1999","journal-title":"Ophthalmology"},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/S0039-6257(98)00004-6","article-title":"Acanthamoeba Keratitis","volume":"42","author":"Illingworth","year":"1998","journal-title":"Surv. Ophthalmol."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/S0161-6420(92)31994-3","article-title":"Treatment of Acanthamoeba Keratitis with Polyhexamethylene Biguanide","volume":"99","author":"Larkin","year":"1992","journal-title":"Ophthalmology"},{"key":"ref_130","first-page":"46","article-title":"Acanthamoeba keratitis: Early diagnosis, rational drug intervention and prevention","volume":"1","author":"Seal","year":"1997","journal-title":"Hong Kong J. Ophthalmol."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.ophtha.2023.09.031","article-title":"The Orphan Drug for Acanthamoeba Keratitis (ODAK) Trial","volume":"131","author":"Dart","year":"2023","journal-title":"Ophthalmology"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.survophthal.2016.12.010","article-title":"Management of high-risk corneal transplantation","volume":"62","author":"Kheirkhah","year":"2017","journal-title":"Surv. Ophthalmol."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/S0002-9394(14)74320-X","article-title":"Medical and Surgical Treatment of Acanthamoeba Keratitis","volume":"103","author":"Cohen","year":"1987","journal-title":"Am. J. Ophthalmol."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1038\/eye.1994.137","article-title":"Drug resistance and Acanthamoeba Keratitis: The quest for alternative antiprotozoal chemotherapy","volume":"8","author":"Hay","year":"1994","journal-title":"Eye"},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/S0002-9394(14)74448-4","article-title":"Combined Treatment of Acanthamoeba Keratitis with Propamidine, Neomycin, and Polyhexamethylene Biguanide","volume":"115","author":"Varga","year":"1993","journal-title":"Am. J. Ophthalmol."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/S0002-9394(14)77020-5","article-title":"Successful Medical Management of Acanthamoeba Keratitis","volume":"110","author":"Berger","year":"1990","journal-title":"Am. J. Ophthalmol."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"725","DOI":"10.26444\/aaem\/99683","article-title":"Effect of povidone iodine, chlorhexidine digluconate and toyocamycin on amphizoic amoebic strains, infectious agents of Acanthamoeba keratitis\u2014A growing threat to human health worldwide","volume":"25","author":"Padzik","year":"2018","journal-title":"Ann. Agric. Env. Med."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"5626","DOI":"10.1128\/AAC.02635-14","article-title":"Cysticidal activity of antifungals against different genotypes of Acanthamoeba","volume":"58","author":"Iovieno","year":"2014","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1038\/s41433-020-1117-4","article-title":"Comparison of two confocal microscopes for diagnosis of acanthamoeba keratitis","volume":"35","author":"Alsoudi","year":"2021","journal-title":"Eye"},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1007\/s00436-017-5377-2","article-title":"Evaluation of the effectiveness of tea tree oil in treatment of Acanthamoeba infection","volume":"116","author":"Derda","year":"2017","journal-title":"Parasitol. Res."},{"key":"ref_141","unstructured":"Somani, S.N., Ronquillo, Y., and Moshirfar, M. (2024). StatPearls, StatPearls Publishing. Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK549863\/."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"2040","DOI":"10.1128\/JCM.00575-09","article-title":"Resistance of Acanthamoeba Cysts to Disinfection in Multiple Contact Lens Solutions","volume":"47","author":"Johnston","year":"2009","journal-title":"J. Clin. Microbiol."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1007\/s002840010325","article-title":"Pathogenicity, morphology, and differentiation of Acanthamoeba","volume":"43","author":"Khan","year":"2001","journal-title":"Curr. Microbiol."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.ajo.2011.07.025","article-title":"Evaluation of in vitro efficacy of combined riboflavin and ultraviolet a for Acanthamoeba isolates","volume":"153","author":"Casas","year":"2012","journal-title":"Am. J. Ophthalmol."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1159\/000331707","article-title":"Ultraviolet-A Light and Riboflavin Therapy for Acanthamoeba Keratitis: A Case Report","volume":"2","year":"2011","journal-title":"Case Rep. Ophthalmol."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.ophtha.2010.06.041","article-title":"Riboflavin and Ultraviolet Light A Therapy as an Adjuvant Treatment for Medically Refractive Acanthamoeba Keratitis","volume":"118","author":"Khan","year":"2011","journal-title":"Ophthalmology"},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.jtos.2019.08.006","article-title":"Photoactivated chromophore for infectious keratitis\u2014Corneal cross-linking (PACK-CXL): A systematic review and meta-analysis","volume":"17","author":"Ting","year":"2019","journal-title":"Ocul. Surf."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.ophtha.2019.08.029","article-title":"Cross-Linking-Assisted Infection Reduction: A Randomized Clinical Trial Evaluating the Effect of Adjuvant Cross-Linking on Outcomes in Fungal Keratitis","volume":"127","author":"Prajna","year":"2020","journal-title":"Ophthalmology"},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/ICO.0000000000000681","article-title":"Early Deep Anterior Lamellar Keratoplasty (DALK) for Acanthamoeba Keratitis Poorly Responsive to Medical Treatment","volume":"35","author":"Sarnicola","year":"2016","journal-title":"Cornea"},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.joco.2018.09.008","article-title":"Acanthamoeba keratitis\u2014Clinical signs, differential diagnosis and treatment","volume":"31","author":"Daas","year":"2019","journal-title":"J. Curr. Ophthalmol."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"2889","DOI":"10.1007\/s10792-019-01137-1","article-title":"Therapeutic penetrating keratoplasty for acanthamoeba keratitis: A review of cases, complications and predictive factors","volume":"39","author":"Roozbahani","year":"2019","journal-title":"Int. Ophthalmol."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/12\/4\/758\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:25:25Z","timestamp":1760106325000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/12\/4\/758"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,9]]},"references-count":151,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["microorganisms12040758"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms12040758","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,9]]}}}