University Institute of Tropical Diseases and Public Health of the Canary Islands, University of La Laguna, Tenerife, Canary Islands, Spain.
Cont Lens Anterior Eye. 2011 Apr;34(2):83-6. doi: 10.1016/j.clae.2010.10.007. Epub 2010 Dec 3.
A case of a 59-year-old Spanish patient who presented with severe ocular pain, blurred vision, eyelid swelling and foreign body sensation in the right eye is reported. She was a regular gas permeable contact lens [corrected] wearer who initially claimed to maintain standard lens care. After exploration, conjunctival injection, dendritiform corneal ulcers and stromal edema were observed. She was initially treated for a possible viral keratitis due to herpes simplex virus using 3% topical acyclovir and 0.1% dexamethasone eye drops 5 times a day. The patient did not respond to this treatment and six weeks later, corneal scrapings were positive for Acanthamoeba genotype T11. She was then treated with chlorhexidine 0.02%, propamidine 0.1% and 1% cycloplegic eye drops hourly which resulted in a significant improvement. After a month, ocular pain decreased and the clinical signs of keratitis ameliorated observed as a diminution of the size of the ulcer and also in the extension and opacity of the corneal infiltrates. The patient has been following this treatment for 3 months and it is possible that she will have to carry on with it for a whole year. To the best of our knowledge, this is the first case of severe keratitis due to Acanthamoeba genotype T11 in Spain .
现报道一例 59 岁西班牙女性患者，其右眼出现严重眼痛、视力模糊、眼睑肿胀和异物感。她是一位经常佩戴透气性角膜接触镜的患者，最初声称遵循标准的镜片护理。经检查，发现结膜充血、树枝状角膜溃疡和基质水肿。由于疑似单纯疱疹病毒引起的病毒性角膜炎，她最初接受了 3%阿昔洛韦滴眼液和 0.1%地塞米松滴眼液 5 次/天的治疗。但患者对此治疗反应不佳，六周后，角膜刮片显示棘阿米巴属 T11 基因型阳性。随后，她接受了 0.02%洗必泰、0.1%丙脒和 1%散瞳滴眼液每小时滴眼治疗，病情显著改善。一个月后，眼部疼痛减轻，角膜炎的临床体征改善，溃疡的大小以及角膜浸润的范围和混浊度均有所缩小。患者已接受该治疗 3 个月，可能需要继续治疗一年。据我们所知，这是西班牙首例由棘阿米巴属 T11 基因型引起的严重角膜炎病例。
