Yang Y F, Matheson M, Dart J K, Cree I A
Moorfields Eye Hospital, London, UK.
Br J Ophthalmol. 2001 Mar;85(3):277-80. doi: 10.1136/bjo.85.3.277.
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
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.
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.
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
探讨棘阿米巴角膜炎后角膜和巩膜持续炎症并非总是由活跃的阿米巴感染引起，而是可能由于持续存在的棘阿米巴抗原这一假说。
从14例连续患者疾病的不同阶段获取24份板层角膜活检和穿透性角膜移植标本，分为显微镜检查和培养两组。组织学切片进行免疫染色，通过光学显微镜筛查棘阿米巴囊肿的存在。使用接种有大肠杆菌的非营养琼脂上的部分匀浆组织进行培养。临床数据从这些患者的病历中回顾性获取。
在24份标本中，20份取自手术时临床有炎症的眼睛。这20份标本中有16份（80%）存在棘阿米巴囊肿，而只有5份（25%）培养呈阳性。发现棘阿米巴囊肿在抗阿米巴治疗后可持续长达31个月。
这些发现支持了以下假说，即棘阿米巴角膜炎后棘阿米巴囊肿可在角膜组织中长时间留存，并且在无活跃阿米巴感染时可能导致角膜和巩膜持续炎症。鉴于这些发现，当炎症是由于残留抗原而非活的病原体引起时，延长强化抗阿米巴治疗可能并不合适
