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Protozoan eye infections: the challenges of human-animal-ecosystem interactions
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Advisor(s)
Abstract(s)
Background. Parasitic infections are significant causes of ophthalmic diseases worldwide, and if not treated timely, they could lead to visual impairment and blindness. Acanthamoeba species and Toxoplasma gondii are the most common protozoal parasites that infect the ocular structure. Prevention methods differ for each pathogen, but several practices are recognized as effective in reducing the risk at the community and personal levels. Education campaigns to promote handwashing after contact with animals and other behavioural adjustments can reduce the community spread of the disease. This study aims to increase awareness of protozoal parasite infections by describing two clinical cases that were diagnosed early and were effectively treated. Methods. A case of a 52-year-old Portuguese man with Acanthamoeba keratitis (patient 1) and a case of a 41-year-old Brazilian man (patient 2) are presented. Complete ophthalmologic examination including best-corrected visual acuity, slit lamp biomicroscopy, dilated biomicroscopic and fundus examinations, specular microscopy, colour fundus photography, and optical coherence tomography was performed at the diagnostic assessment and during the follow-up. The therapeutic strategy was a combination of classic therapy, anti-parasitic, and supplementation (antiinflammatory, pro-immune, and antioxidant properties) that modulate the host immune response. Results. Patient 1 was diagnosed with Acanthamoeba keratitis in both eyes after abusive use of contact lenses; all layers of corneal structure were damaged with higher severity in the left eye; the patient had light perception, photophobia, and hyperaemia; a therapeutic protocol with anti-fungal, anti-septic, anti-parasitic, artificial tear eye drops, vitamin C, D, zinc, copper and selenium was prescribed; after six weeks the patient presented maximum (1.0) visual acuity in both eyes and recovery of corneal layers, with guttate endothelium; non-use of contact lenses was indicated until total infection control. Patient 2 was diagnosed with Toxoplasmosis in the right eye with chorioretinal lesions; the patient was only able to see hand movements; a therapeutic protocol with antibiotic, anti-inflammatory, corticosteroids, bacterial folic acid inhibitor, vitamin C, D, zinc, copper, and selenium was prescribed; after four weeks the patient present better (0.3) visual acuity, resorptive chorioretinal lesion; dietary care recommendations were made. Conclusions. Our results support that early detection (by ocular imaging) and pharmacological therapy (that supports the immune system) lead to recovery of visual function and improvement in quality of life. Health promotion activities and community engagement may be critical to promoting habits and attitudes that reduce the risk of infections, supporting early detection and containment of disease threats. Eye health professionals may be key players in supporting The One Health approach regarding protozoan eye infections.
Description
Keywords
Ophthalmology Parasitic infections Protozoan eye infection Case report
Citation
Fernandes N, Araújo M, Carvalho T, Lança C. Protozoan eye infections: the challenges of human-animal-ecosystem interactions. In: 1st Egas Moniz One Health Symposium, Monte da Caparica, November 3, 2022.