Subepithelial Infiltrates in Acanthamoeba Keratitis

Holland, Edward J.; Alul, Ida H.; Meisler, David M.; Epstein, Randy J.; Rotkis, Walter M.; Nathenson, Aaron L.; Liesegang, Thomas J.

doi:10.1016/s0002-9394(14)76250-6

Cited by 20 publications

(7 citation statements)

References 10 publications

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“…Furthermore, our clinical experience as well as that of Holland et al 10 of successfully treating post-acanthamoeba keratitis associated corneal and scleral inflammation with topical and/or systemic immunosuppressive therapy conform with the above hypothesis.…”

Section: Discussionsupporting

confidence: 84%

Persistence of acanthamoeba antigen following acanthamoeba keratitis

Yang

Matheson²,

Dart³

et al. 2001

British Journal of Ophthalmology

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Aim-To investigate the hypothesis that persistent corneal and scleral inflammation following acanthamoeba keratitis is not always caused by active amoebic infection but can be due to persisting acanthamoebic antigens Methods-24 lamellar corneal biopsy and penetrating keratoplasty specimens were obtained from 14 consecutive patients at various stages of their disease and divided for microscopy and culture. Histological sections were immunostained and screened for the presence of Acanthamoeba cysts by light microscopy. Cultures were carried out using partly homogenised tissues on non-nutrient agar seeded with E coli. Clinical data were obtained retrospectively from the case notes of these patients. Results-Of the 24 specimens, 20 were obtained from eyes that were clinically inflamed at the time of surgery. Acanthamoeba cysts were present in 16 (80%) of these 20 specimens, while only five (25%) were culture positive. Acanthamoeba cysts were found to persist for up to 31 months after antiamoebic treatment. Conclusion-These findings support the hypothesis that Acanthamoeba cysts can remain in corneal tissue for an extended period of time following acanthamoeba keratitis and may cause persistent corneal and scleral inflammation in the absence of active amoebic infection. In view of these findings, prolonged intensive antiamoebic therapy may be inappropriate when the inflammation is due to retained antigen rather than to viable organisms (Br J Ophthalmol 2001;85:277-280)

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Section: Discussionsupporting

confidence: 84%

Persistence of acanthamoeba antigen following acanthamoeba keratitis

Yang

Matheson²,

Dart³

et al. 2001

British Journal of Ophthalmology

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“…They were less dense than those described by Holland et al (1991) and resembled nummular infiltrates in adenoviral keratitis. The subepithelial infiltrates described by Holland et al (1991) in six patients occurred up to 18 months after onset of Acanthamoeba keratitis, mostly when the patients were still receiving topical corticosteroids. In our case, the infiltrates disappeared when topical cyclosporin A was administered.…”

contrasting

confidence: 48%

“…Epithelial irregularities (Cohen et al 1987; Bacon et al 1993) and stromal infiltrates (Illingworth & Cook 1998) are common, but less typical. Dense subepithelial infiltrates were described by Holland et al (1991). Here, we present a patient with Acanthamoeba keratitis showing subepithelial infiltrates similar to nummular infiltrates in adenoviral keratitis.…”

mentioning

confidence: 99%

Nummular infiltrates in Acanthamoeba keratitis

Reinhard¹,

Schilgen

Steinert³

et al. 2003

Acta Ophthalmologica Scandinavica

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“…Nummular subepithelial infiltrates have been described as an uncommon presenting sign of Acanthamoeba keratitis 13–16 . These infiltrates are similar to those observed in adenoviral keratitis and therefore have been the cause of initial misdiagnosis.…”

Section: Signsmentioning

confidence: 93%

“…It has been suggested that subepithelial infiltrates in Acanthamoeba keratitis may be the result of an immune reaction against Acanthamoeba antigens 16 …”

Section: Signsmentioning

confidence: 99%

Acanthamoeba keratitis: a comprehensive photographic reference of common and uncommon signs

Patel

McGhee

2009

Clinical Exper Ophthalmology

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There has been a significant increase in the number of reported cases of Acanthamoeba keratitis reported internationally over the last 24 months. Diagnosing Acanthamoeba keratitis is often difficult and part of the difficulty is attributed to the variability of presentation. This article provides a comprehensive photographic reference of common and uncommon clinical signs of Acanthamoeba keratitis.

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Subepithelial Infiltrates in Acanthamoeba Keratitis

Cited by 20 publications

References 10 publications

Persistence of acanthamoeba antigen following acanthamoeba keratitis

Persistence of acanthamoeba antigen following acanthamoeba keratitis

Nummular infiltrates in Acanthamoeba keratitis

Acanthamoeba keratitis: a comprehensive photographic reference of common and uncommon signs

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