Holland E J, Alul I H, Meisler D M, Epstein R J, Rotkis W M, Nathenson A L, Liesegang T J
Department of Ophthalmology, University of Minnesota, Minneapolis.
Am J Ophthalmol. 1991 Oct 15;112(4):414-8. doi: 10.1016/s0002-9394(14)76250-6.
Six patients had Acanthamoeba keratitis that manifested an unusual type of subepithelial corneal infiltrate late in the course of the disease. These infiltrates occurred in the anterior corneal stroma, often in a location removed from the site of infection. In four of these patients the infiltrates occurred with no other clinical signs of inflammation. Two patients had mild foreign-body sensation that resolved despite the persistence of the subepithelial infiltrates. The infiltrates resolved with topical corticosteroid therapy in three patients; however, in two of these three patients the infiltrates recurred when corticosteroid therapy was tapered or discontinued. The subepithelial infiltrates appeared and behaved similarly to those associated with viral and chlamydial corneal infections. An immunologic mechanism may be responsible for these unusual delayed-in-onset infiltrates.
6例棘阿米巴角膜炎患者在病程后期出现一种不寻常类型的角膜上皮下浸润。这些浸润出现在角膜前基质层，常常位于远离感染部位的地方。在其中4例患者中，浸润出现时无其他炎症的临床体征。2例患者有轻度异物感，尽管角膜上皮下浸润持续存在，但异物感仍消退。3例患者经局部皮质类固醇治疗后浸润消退；然而，在这3例患者中的2例，当皮质类固醇治疗逐渐减量或停药时，浸润复发。角膜上皮下浸润的出现及表现与病毒和衣原体角膜感染相关的浸润相似。免疫机制可能是这些不寻常的迟发性浸润的原因。
