Witschel H, Sundmacher R, Seitz H M
Klin Monbl Augenheilkd. 1984 Jul;185(1):46-9. doi: 10.1055/s-2008-1054568.
The present paper describes a case of amebic keratitis in a 63-year-old female patient, who had been wearing hard contact lenses to correct myopia. The clinical course was characterized by early superficial corneal infiltrates accompanied by a marked iritis and excruciating pain. Later a ring abscess developed, combined with a disciform infiltration of the deep central stroma and a recalcitrant superficial corneal ulcer. The disease ran a very chronic course over more than 3 months. After various conservative treatments including topical steroids, antibiotics, antimycotic, and antiviral drugs, a penetrating keratoplasty had to be performed. The histopathologic examination of the corneal button revealed many encysted amebas and a few trophozoites which were classified by direct immunofluorescence as belonging to the genus Acanthamoeba (Hartmannella). Six months after keratoplasty the eye was quit without any signs of recurrence. As far as the authors know, this is the first reported case of an amebic keratitis associated with contact lenses.
本文描述了一名63岁女性患者的阿米巴性角膜炎病例，该患者一直佩戴硬性隐形眼镜矫正近视。临床病程特点为早期角膜浅层浸润，伴有明显虹膜炎和剧痛。随后出现环形脓肿，合并中央深层基质盘状浸润和顽固性角膜浅表溃疡。疾病持续了3个多月，病程非常漫长。在包括局部使用类固醇、抗生素、抗真菌和抗病毒药物在内的各种保守治疗后，不得不进行穿透性角膜移植术。角膜植片的组织病理学检查显示有许多包囊型阿米巴和一些滋养体，通过直接免疫荧光法分类属于棘阿米巴属（哈特曼阿米巴属）。角膜移植术后6个月，患眼无任何复发迹象。据作者所知，这是首例报道的与隐形眼镜相关的阿米巴性角膜炎病例。
