棘阿米巴性硬化性角膜炎
Acanthamoeba sclerokeratitis.
作者信息
Ebrahimi Katayoon B, Green W Richard, Grebe Rhonda, Jun Albert S
机构信息
Eye Pathology Laboratory and Cornea/External Disease Service, Wilmer Eye Institute and Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
出版信息
Graefes Arch Clin Exp Ophthalmol. 2009 Feb;247(2):283-6. doi: 10.1007/s00417-008-0955-8. Epub 2008 Oct 9.
BACKGROUND
Acanthamoeba scleritis is an uncommon but severe complication of acanthamoeba keratitis. We report the clinical and histopathologic features of a patient with acanthamoeba sclerokeratitis.
METHODS
Review of the patient's clinical records and histopathologic examination of the globe including light microscopy and transmission electron microscopy.
RESULTS
Review of the clinical record of the patient revealed a past ocular history of penetrating keratoplasty for persistent acanthamoeba keratitis. Later in the course of treatment, the patient developed nodular necrotizing scleritis with culture-proven viable acanthamoeba in this area. She underwent enucleation of the eye for persistent acanthamoeba sclerokeratitis. Histopathologic examination of the globe revealed no acanthamoeba cysts or trophozoites at the site of crotherapy.
CONCLUSION
Our study provides evidence for the invasion of acanthamoeba organisms into the sclera in a case of acanthamoeba keratitis. The presence of trophozites in scleral tissue may exacerbate the immune response leading to nodular scleritis.
背景
棘阿米巴性巩膜炎是棘阿米巴角膜炎一种罕见但严重的并发症。我们报告了一例棘阿米巴性硬化性角膜炎患者的临床和组织病理学特征。
方法
回顾患者的临床记录，并对眼球进行组织病理学检查，包括光学显微镜和透射电子显微镜检查。
结果
回顾患者的临床记录显示，患者既往有因持续性棘阿米巴角膜炎行穿透性角膜移植术的眼部病史。在治疗过程中，患者出现结节性坏死性巩膜炎，该区域经培养证实有存活的棘阿米巴。她因持续性棘阿米巴性硬化性角膜炎接受了眼球摘除术。眼球的组织病理学检查显示，在冷冻治疗部位未发现棘阿米巴囊肿或滋养体。
结论
我们的研究为一例棘阿米巴角膜炎病例中棘阿米巴生物体侵入巩膜提供了证据。巩膜组织中滋养体的存在可能会加剧免疫反应，导致结节性巩膜炎。
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