Department of Ophthalmology, China Medical University, the First Affiliated Hospital, Shenyang, China.
Histopathology. 2013 Dec;63(6):862-8. doi: 10.1111/his.12237. Epub 2013 Sep 23.
To classify the clinical stages of Acanthamoeba keratitis (AK), and clarify the relationship between pathological changes and clinical features.
Between January 2007 and May 2012, AK was diagnosed in 11 eyes by pathological examination and confocal laser scanning microscopy. Pathological investigation of all cornea samples from keratoplasty was done with periodic acid-Schiff and haematoxylin and eosin stains. AK clinical stage, pathological features and postoperative treatment were studied retrospectively. The 11 cases were classified into development stage, convalescence stage, or cicatricial stage. In the development stage, marked conjunctival hyperaemia, a corneal epithelial defect, obvious corneal infiltration and progressive inflammation were seen; pathological changes comprised abundant inflammatory cells and a rounded cyst in the oedematous stroma, as well as a very small amount of neovascularization. In the convalescence cases, moderate conjunctival hyperaemia, corneal disciform structures, repair of the corneal epithelial defect and abundant neovascularization were seen; pathological changes included significant tissue necrosis and a small, shrunken cyst in the stroma, as well as significant neovascularization. In the cicatricial stage, keratoleukoma was seen; pathological changes comprised a few inflammatory cells and shrunken cysts scattered in the stroma. There were no cases of recurrence.
The pathological features of different clinical stages confirmed the new clinical classification of AK.
对棘阿米巴角膜炎（AK）的临床分期进行分类，并阐明其病理变化与临床特征之间的关系。
2007 年 1 月至 2012 年 5 月期间，通过病理检查和共聚焦激光扫描显微镜诊断了 11 只眼的 AK。对所有角膜移植术中的角膜样本进行了过碘酸雪夫和苏木精-伊红染色的病理检查。回顾性研究 AK 的临床分期、病理特征和术后治疗。11 例患者分为发展期、恢复期或瘢痕期。在发展期，可见明显的结膜充血、角膜上皮缺损、明显的角膜浸润和进行性炎症；病理变化包括水肿基质中丰富的炎症细胞和圆形包囊，以及少量的新生血管。在恢复期，可见中度结膜充血、角膜盘状结构、角膜上皮缺损修复和丰富的新生血管；病理变化包括显著的组织坏死和基质中小而萎缩的包囊，以及显著的新生血管。在瘢痕期，可见角膜白斑；病理变化包括基质中散在的少量炎症细胞和萎缩的包囊。无复发病例。
不同临床分期的病理特征证实了 AK 的新临床分类。
