Аcanthamoeba keratitis and outcomes of the treatment (clinical cases)

Acanthamoeba keratitis (AK) — corneal inflammation caused by protozoa — Acanthamoeba. The disease is related mainly with wearing of contact lens, pathogen — Acanthamoeba penetrates under the contact lenses. The cases of AK after Lasik are described. Corneal epithelium microtrauma and contact with so...

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Main Authors: M. M. Bikbov, V. K. Surkova, E. L. Usubov, N. A. Nikitin
Format: Article
Language:Russian
Published: Ophthalmology Publishing Group 2016-01-01
Series:Oftalʹmologiâ
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Online Access:https://www.ophthalmojournal.com/opht/article/view/281
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author M. M. Bikbov
V. K. Surkova
E. L. Usubov
N. A. Nikitin
author_facet M. M. Bikbov
V. K. Surkova
E. L. Usubov
N. A. Nikitin
author_sort M. M. Bikbov
collection DOAJ
description Acanthamoeba keratitis (AK) — corneal inflammation caused by protozoa — Acanthamoeba. The disease is related mainly with wearing of contact lens, pathogen — Acanthamoeba penetrates under the contact lenses. The cases of AK after Lasik are described. Corneal epithelium microtrauma and contact with sources of environmental pollution are the risk factors of the invasion of Acanthamoeba into the cornea.Acanthamoebas affect soil, stagnant reservoirs, swimming pools, drain pipes, tap water, etc. Diagnosis can be confirmed only when cysts are detected in cornea material, plate count, smear, and the containers where such material is stored. Long life cycle including cyst stage helps keratitis relapsing course last for months. It is not always possible to detect cysts. Assessment of etiology presents certain difficulties.Such aspects as history taking, monitoring the clinical course of disease, confocal microscopy that enables to reveal acanthamoebas in vivo help to determine a diagnosis.Disease is characterized by a long chronic course with the development descemetocele and cornea perforation. The sequence of remissions and exacerbations of inflammation, apparently, occurs due to peculiarities of Acanthamoeba life cycle. Acanthamoeba keratitis is difficult to treat, it’s resistant to antibiotics. Untimely diagnosed disease and delayed initiation of treatment in patients with AK promote corneal perforation and inflammatory process in deep eye structures what often leads to eye enucleation.Severe pain is typical for AK in onset of disease. It is caused by emergence of subepithelial infiltrates and defects along the nerve fibers located in the most sensitive surface layer of the cornea. Conservative treatment is conducted with the use of antiseptics. The most effective one against cysts is 0.02% chlorhexidine which is prepared ex. temporae.The article presents the peculiarities of clinical course of Acanthamoeba keratitis, clinical cases of the disease and the results of penetrating keratoplasty as the main method of treatment of severe AK.
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spelling doaj-art-5faf00d3bc504b16abf111d895b25dff2025-08-20T02:56:15ZrusOphthalmology Publishing GroupOftalʹmologiâ1816-50952500-08452016-01-01124808310.18008/1816-5095-2015-4-80-83271Аcanthamoeba keratitis and outcomes of the treatment (clinical cases)M. M. Bikbov0V. K. Surkova1E. L. Usubov2N. A. Nikitin3Ufa Eye Research InstituteUfa Eye Research InstituteUfa Eye Research InstituteUfa Eye Research InstituteAcanthamoeba keratitis (AK) — corneal inflammation caused by protozoa — Acanthamoeba. The disease is related mainly with wearing of contact lens, pathogen — Acanthamoeba penetrates under the contact lenses. The cases of AK after Lasik are described. Corneal epithelium microtrauma and contact with sources of environmental pollution are the risk factors of the invasion of Acanthamoeba into the cornea.Acanthamoebas affect soil, stagnant reservoirs, swimming pools, drain pipes, tap water, etc. Diagnosis can be confirmed only when cysts are detected in cornea material, plate count, smear, and the containers where such material is stored. Long life cycle including cyst stage helps keratitis relapsing course last for months. It is not always possible to detect cysts. Assessment of etiology presents certain difficulties.Such aspects as history taking, monitoring the clinical course of disease, confocal microscopy that enables to reveal acanthamoebas in vivo help to determine a diagnosis.Disease is characterized by a long chronic course with the development descemetocele and cornea perforation. The sequence of remissions and exacerbations of inflammation, apparently, occurs due to peculiarities of Acanthamoeba life cycle. Acanthamoeba keratitis is difficult to treat, it’s resistant to antibiotics. Untimely diagnosed disease and delayed initiation of treatment in patients with AK promote corneal perforation and inflammatory process in deep eye structures what often leads to eye enucleation.Severe pain is typical for AK in onset of disease. It is caused by emergence of subepithelial infiltrates and defects along the nerve fibers located in the most sensitive surface layer of the cornea. Conservative treatment is conducted with the use of antiseptics. The most effective one against cysts is 0.02% chlorhexidine which is prepared ex. temporae.The article presents the peculiarities of clinical course of Acanthamoeba keratitis, clinical cases of the disease and the results of penetrating keratoplasty as the main method of treatment of severe AK.https://www.ophthalmojournal.com/opht/article/view/281acanthamoeba keratitisclinical casespenetrating keratoplasty
spellingShingle M. M. Bikbov
V. K. Surkova
E. L. Usubov
N. A. Nikitin
Аcanthamoeba keratitis and outcomes of the treatment (clinical cases)
Oftalʹmologiâ
acanthamoeba keratitis
clinical cases
penetrating keratoplasty
title Аcanthamoeba keratitis and outcomes of the treatment (clinical cases)
title_full Аcanthamoeba keratitis and outcomes of the treatment (clinical cases)
title_fullStr Аcanthamoeba keratitis and outcomes of the treatment (clinical cases)
title_full_unstemmed Аcanthamoeba keratitis and outcomes of the treatment (clinical cases)
title_short Аcanthamoeba keratitis and outcomes of the treatment (clinical cases)
title_sort аcanthamoeba keratitis and outcomes of the treatment clinical cases
topic acanthamoeba keratitis
clinical cases
penetrating keratoplasty
url https://www.ophthalmojournal.com/opht/article/view/281
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AT vksurkova acanthamoebakeratitisandoutcomesofthetreatmentclinicalcases
AT elusubov acanthamoebakeratitisandoutcomesofthetreatmentclinicalcases
AT nanikitin acanthamoebakeratitisandoutcomesofthetreatmentclinicalcases