Moshari A, McLean I W, Dodds M T, Damiano R E, McEvoy P L
Department of Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
Ophthalmology. 2001 Dec;108(12):2232-6. doi: 10.1016/s0161-6420(01)00765-5.
A clinicopathologic study to evaluate the histopathologic features associated with Acanthamoeba keratitis and chorioretinitis.
Retrospective observational case report.
On the basis of the clinical history and histologic appearance, the enucleated eye and native corneal button were examined using hematoxylin-eosin stains and special periodic acid-Schiff and Gomori methenamine silver stains.
Results of histologic examination of the cornea and retina showed numerous Acanthamoeba cysts in the cornea stromal layers, the necrotic retina, and preretinal and subretinal spaces.
To the authors' knowledge, this is the first proven histologic case of ipsilateral chorioretinitis secondary to primary chronic keratitis caused by Acanthamoeba. The patient had a 30-month history of recurrent keratitis requiring four penetrating keratoplasties. We believe the chorioretinitis resulted from direct spread of the corneal amebic infection. The spread of the Acanthamoeba may have been facilitated by a combined keratoplasty, extracapsular cataract extraction, and intraocular lens insertion. In both specimens, the native corneal button and the enucleated eye with a corneal transplant, the general pathologists overlooked the presence of Acanthamoeba.
进行一项临床病理研究，以评估与棘阿米巴角膜炎和脉络膜视网膜炎相关的组织病理学特征。
回顾性观察病例报告。
根据临床病史和组织学表现，使用苏木精-伊红染色以及特殊的过碘酸-希夫染色和戈莫里六胺银染色对摘除的眼球和天然角膜植片进行检查。
角膜和视网膜的组织学检查结果显示，在角膜基质层、坏死的视网膜以及视网膜前和视网膜下间隙中有大量棘阿米巴囊肿。
据作者所知，这是首例经证实的由棘阿米巴引起的原发性慢性角膜炎继发同侧脉络膜视网膜炎的组织学病例。该患者有30个月的复发性角膜炎病史，需要进行4次穿透性角膜移植术。我们认为脉络膜视网膜炎是由角膜阿米巴感染直接蔓延所致。棘阿米巴的传播可能因角膜移植、囊外白内障摘除术和人工晶状体植入术的联合操作而加剧。在天然角膜植片和带有角膜移植的摘除眼球这两个标本中，普通病理学家均忽略了棘阿米巴的存在。
