Liu X H, Li J, Yin R J, Yuan M, Han L, Li X H
Department of Ophthalmology, Henan Provincial People's Hospital, Henan Eye Institute, Henan Eye Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou 450003, China.
Zhonghua Yan Ke Za Zhi. 2021 Dec 11;57(12):939-943. doi: 10.3760/cma.j.cn112142-20210623-00304.
To study the relationship between the clinical characteristics and the histopathological changes in acanthamoeba keratitis. In this retrospective study, the clinical data and histopathological features of 15 Acanthamoeba keratitis patients (15 eyes) treated in Henan Eye Hospital were collected and analyzed. There were 8 males and 7 females. Mean age was 49.2 years old. The corneal specimens were stained with hematoxylin eosin, periodic acid-schiff, Gomori's methenamine silver, Gram and Gimsa respectively. The pathological changes and characteristics were observed under microscope, to analyze the relationship between histopathology and clinical features. All patients had moderate conjunctival congestion. Five patients showed corneal ring stromal infiltration, 8 had central corneal ulcers, 1 had corneal opacity, and 1 had a matrix ulcer. We found corneal neovascularization around the ulcer in 4 eyes and a dense ulcer in 2 eyes. Histopathological examinations with hematoxylin-eosin, periodic acid-Schiff, Gomori's methenamine silver, Gram and Giemsa stainings revealed round or oval amoebic cysts and amebic trophozoites which were of an elongated oval, spine-or spear-like. Twelve patients (80%) showed corneal stromal purulent inflammation infiltrated by neutrophils. Many degenerated amoebic cysts were found. Degeneration and necrosis of corneal stromal fibers were observed in 3 eyes (20%). There were no neutrophils. Amoebic cysts were seen in necrotic tissue. Ten eyes (66.7%) had no inflammatory cell infiltration areas, with edematous or mildly degenerated corneal fibers, scattered or grouped cysts and trophozoites. Clinical manifestations of acanthamoeba keratitis are various. Acanthamoeba cysts and trophozoites also exist in the transparent corneal area on the histopathological examination. This is important for the therapeutic outcomes. .
研究棘阿米巴角膜炎的临床特征与组织病理学变化之间的关系。在这项回顾性研究中，收集并分析了河南眼科医院收治的15例棘阿米巴角膜炎患者（15只眼）的临床资料和组织病理学特征。其中男性8例，女性7例。平均年龄49.2岁。角膜标本分别用苏木精伊红、过碘酸希夫、Gomori六胺银、革兰氏和吉姆萨染色。在显微镜下观察病理变化和特征，以分析组织病理学与临床特征之间的关系。所有患者均有中度结膜充血。5例患者表现为角膜环形基质浸润，8例有中央角膜溃疡，1例有角膜混浊，1例有基质溃疡。我们发现4只眼在溃疡周围有角膜新生血管，2只眼有致密溃疡。苏木精-伊红、过碘酸希夫、Gomori六胺银、革兰氏和吉姆萨染色的组织病理学检查显示圆形或椭圆形的阿米巴囊肿和呈细长椭圆形、有刺或矛状的阿米巴滋养体。12例患者（80%）表现为角膜基质脓性炎症，有中性粒细胞浸润。发现许多退化的阿米巴囊肿。3只眼（20%）观察到角膜基质纤维变性和坏死。无中性粒细胞。在坏死组织中可见阿米巴囊肿。10只眼（66.7%）无炎症细胞浸润区，角膜纤维水肿或轻度变性，囊肿和滋养体散在或成组分布。棘阿米巴角膜炎的临床表现多样。组织病理学检查还发现透明角膜区域存在棘阿米巴囊肿和滋养体。这对治疗结果很重要。
