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棘阿米巴角膜炎的发病机制、危险因素、诊断与治疗

The pathogenesis, risk factors, diagnosis and treatment of Acanthamoeba keratitis.

作者信息

Bao Mingliang, Bao Hai, Wang Shuqing, Zhou Hongyan

机构信息

Department of Ophthalmology, China-Japan Union Hospital of Jilin University, Changchun, China.

Department of Cataract, Changchun Aier Eye Hospital, Changchun, China.

出版信息

Front Med (Lausanne). 2025 Jul 24;12:1559224. doi: 10.3389/fmed.2025.1559224. eCollection 2025.

Abstract

Acanthamoeba keratitis (AK) is a rare corneal disease that can lead to permanent visual impairment. Its incidence is relatively low when compared with that of other forms of infectious keratitis. As early clinical diagnosis of AK is challenging (e.g., overlapping symptoms, lack of specific diagnostic tools, etc.), it is often misdiagnosed as other types of infectious keratitis, such as viral keratitis or fungal keratitis. Once a patient is diagnosed with AK, the prognosis is extremely poor unless an early start of an aggressive treatment program is implemented, as timely diagnosis and treatment are closely related to a good prognosis. AK can be diagnosed through corneal scraping, culture, polymerase chain reaction, or confocal microscopy. Drug treatment typically involves a combination of biguanide and diamine. In advanced stages of the disease, corneal transplantation is required. This review focuses on the pathogenesis, risk factors, early diagnosis, and treatment of Acanthamoeba keratitis. This review aims to enhance the understanding of Acanthamoeba keratitis.

摘要

棘阿米巴角膜炎(AK)是一种罕见的角膜疾病,可导致永久性视力损害。与其他形式的感染性角膜炎相比,其发病率相对较低。由于AK的早期临床诊断具有挑战性(例如症状重叠、缺乏特异性诊断工具等),它常被误诊为其他类型的感染性角膜炎,如病毒性角膜炎或真菌性角膜炎。一旦患者被诊断为AK,除非尽早开始积极的治疗方案,否则预后极差,因为及时诊断和治疗与良好的预后密切相关。AK可通过角膜刮片、培养、聚合酶链反应或共聚焦显微镜检查进行诊断。药物治疗通常采用双胍类和二胺类药物联合使用。在疾病的晚期阶段,需要进行角膜移植。本综述重点关注棘阿米巴角膜炎的发病机制、危险因素、早期诊断和治疗。本综述旨在增进对棘阿米巴角膜炎的了解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61c9/12328393/9f0be945e822/fmed-12-1559224-g001.jpg

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