Hou Tzu-Yu, Chen Yun-Chen, Hsu Chih-Chien
Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Ophthalmology, Cheng Hsin General Hospital, Taipei, Taiwan.
Taiwan J Ophthalmol. 2017 Oct-Dec;7(4):224-226. doi: 10.4103/tjo.tjo_73_17.
Acanthamoeba keratitis (AK) is an unusual infectious disease of the cornea which sometimes leads to blindness. We report the experience of adding oral voriconazole in conjunction with topical antiacanthamoebic drops to treat refractory AK. A 20-year-old girl experienced a deep stromal keratitis with large epithelial defect in the left eye, suspected as AK. The initial best-corrected visual acuity (BCVA) of the eye was counting finger. She received topical chlorhexidine 0.02% and voriconazole 1% during the first 14 days but in vain. Oral voriconazole was administered and resulted in a rapid regression of the lesion. A total resolution was achieved after 2 weeks of triple combination therapy. The BCVA of the left eye finally achieved 20/20 at 6-month follow-up. Although oral voriconazole was seldom used in treating acute AK, the additional use of oral voriconazole combined with topical antiacanthamoebic drugs may help to achieve a successful treatment effect in refractory stromal AK.
棘阿米巴角膜炎（AK）是一种不常见的角膜感染性疾病，有时会导致失明。我们报告了联合使用口服伏立康唑和局部抗棘阿米巴滴眼液治疗难治性AK的经验。一名20岁女孩左眼出现伴有大面积上皮缺损的深层基质角膜炎，怀疑为AK。该眼最初的最佳矫正视力（BCVA）为指数。在最初的14天里，她接受了0.02%的洗必泰和1%的伏立康唑局部治疗，但无效。给予口服伏立康唑后，病变迅速消退。三联联合治疗2周后完全治愈。在6个月的随访中，左眼的BCVA最终达到了20/20。虽然口服伏立康唑很少用于治疗急性AK，但额外使用口服伏立康唑联合局部抗棘阿米巴药物可能有助于在难治性基质性AK中取得成功的治疗效果。
