title: [Evaluation of in vitro efficacy of combined riboflavin and ultraviolet-A (365 nm) for Acanthamoeba].
abstract: BACKGROUND
  Acanthamoeba keratitis is a rare but serious disease and is particularly difficult to treat when the diagnosis is delayed, partly because of the limitations of current therapies. The purpose of our study is to evaluate the anti-amoebic effectiveness of riboflavin and UV-A on Acanthamoeba castellani.
  
  
  METHODS
  We tested the effect of 0.02% chlorhexidine alone (C), the combination of riboflavin 1% and UV-A (UV-A+R), and the combination of the two treatments (R+C+UV-A) on cultures of vegetative and cystic forms of A. castellani. We conducted a parasite count under optical microscopy for each treated area at day 1, 4 and 8.
  
  
  RESULTS
  There was a decrease in the number of cysts for all three treatments (C, UV-A+R, R+C+UV-A). This reduction was greater for the plates treated with R+UV-A (P <0.01 at D8) and those treated with C+R+UV-A (P<0.001 at D8) compared to those exposed to chlorhexidine alone (C). There was no decrease in the number of amoebic trophozoites for the three treatments (C, UV-A+R, R+C+UV-A), but encystment was observed.
  
  
  CONCLUSIONS
  Given the in vitro efficacy of riboflavin combined with UV-A against cystic forms of A. castellani and excellent in vivo tolerance of the procedure, the treatment of acanthamoeba keratitis might be improved by this new therapeutic approach.
authors: Centre ophtalmologique Malraux, 32, rue du bassin d'Austerlitz, Presqu'île André-Malraux, 67100 Strasbourg, France.
authors: J
authors: J
authors: Letsch
authors: Institut de parasitologie et de maladies tropicales, hôpitaux universitaires de Strasbourg, 1, rue Koeberlé, 67000 Strasbourg, France.
authors: A
authors: A
authors: Abou-Bacar
authors: Institut de parasitologie et de maladies tropicales, hôpitaux universitaires de Strasbourg, 1, rue Koeberlé, 67000 Strasbourg, France.
authors: E
authors: E
authors: Candolfi
authors: Service d'ophtalmologie, hôpitaux universitaires de Strasbourg, Nouvel Hôpital Civil, 67091 Strasbourg cedex, France.
authors: T
authors: T
authors: Bourcier
authors: Service d'ophtalmologie, hôpitaux universitaires de Strasbourg, Nouvel Hôpital Civil, 67091 Strasbourg cedex, France. Electronic address: arnaud.sauer@chru-strasbourg.fr.
authors: A
authors: A
authors: Sauer
mesh_terms: D015823:Acanthamoeba Keratitis / Q000469:parasitology / Q000628:therapy*; D048248:Acanthamoeba castellanii / Q000187:drug effects* / Q000528:radiation effects*; D002710:Chlorhexidine / Q000494:pharmacology; D006801:Humans; D066298:In Vitro Techniques; D008853:Microscopy; D000069289:Parasite Encystment / Q000187:drug effects / Q000528:radiation effects; D012256:Riboflavin / Q000494:pharmacology*; D014466:Ultraviolet Rays
chemical_list: D002710:Chlorhexidine; D012256:Riboflavin
keywords: Acanthamoeba; Cross-linking; Keratitis; Kératite; Riboflavine; Ultraviolet-A