Diagnostic utility of in vivo confocal microscopy in Acanthamoeba keratitis following corneal crosslinking.
| Autor: | Kong CF; The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia ccfkong@gmail.com.; Westmead Hospital, Westmead, New South Wales, Australia., Go C; The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia.; Westmead Hospital, Westmead, New South Wales, Australia., Goolam S; The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia.; Westmead Hospital, Westmead, New South Wales, Australia., Yeung S; Westmead Hospital, Westmead, New South Wales, Australia. |
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| Jazyk: | angličtina |
| Zdroj: | BMJ case reports [BMJ Case Rep] 2024 May 21; Vol. 17 (5). Date of Electronic Publication: 2024 May 21. |
| DOI: | 10.1136/bcr-2023-257279 |
| Abstrakt: | Acanthamoeba keratitis (AK) is a rare but potentially sight-threatening complication of corneal collagen crosslinking (CXL) for keratoconus. In this report, we describe an early adolescent male who underwent routine CXL for progressive keratoconus in his left eye. Preprocedural left visual acuity (VA) was 6/9. At day 5 postprocedure, multifocal corneal infiltrates were identified. Corneal scrape, bandage contact lens cultures and herpetic and Acanthamoeba PCR were negative. In vivo, confocal microscopy (IVCM) identified Acanthamoeba cysts within the corneal stroma. Intensive amoebicidal therapy was initiated, but recovery was complicated by significant inflammation, resulting in widespread aggressive corneal vascularisation necessitating topical steroids and steroid-sparing agents. At 10 months, his left VA was 6/24. This report emphasises the importance of maintaining a high index of suspicion for AK in cases of post-CXL microbial keratitis and highlights the diagnostic value of IVCM, particularly in culture-negative and PCR-negative cases. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.) |
| Databáze: | MEDLINE |
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