Clinical signs and medical therapy of early Acanthamoeba keratitis
T. D. Lindquist, N. A. Sher and D. J. Doughman
Department of Ophthalmology, University of Washington School of Medicine, Seattle.
Several diagnostic signs of Acanthamoeba keratitis have been reported
recently. We treated three patients who developed a dendritiform epithelial
pattern seen early in the course of Acanthamoeba keratitis that likely
represents epithelial infection by Acanthamoeba before any stromal
involvement. In these three cases, the early diagnosis of Acanthamoeba
keratitis coupled with wide epithelial debridement and medical therapy
proved effective in eradicating the protozoan. In two additional cases,
Acanthamoeba keratitis was not diagnosed until significant stromal
involvement was present. Medical therapy was effective in eradicating the
organism in one case, although penetrating keratoplasty was necessary for
visual rehabilitation. In the other case, medical therapy was ineffective,
as corneal perforation resulted and Acanthamoeba cysts were demonstrated by
fluorescent staining in the host corneal button.
