Acanthamoeba sclerokeratitis.
BACKGROUND
Acanthamoeba scleritis is an uncommon but severe complication of acanthamoeba keratitis. We report the clinical and histopathologic features of a patient with acanthamoeba sclerokeratitis.


METHODS
Review of the patient's clinical records and histopathologic examination of the globe including light microscopy and transmission electron microscopy.


RESULTS
Review of the clinical record of the patient revealed a past ocular history of penetrating keratoplasty for persistent acanthamoeba keratitis. Later in the course of treatment, the patient developed nodular necrotizing scleritis with culture-proven viable acanthamoeba in this area. She underwent enucleation of the eye for persistent acanthamoeba sclerokeratitis. Histopathologic examination of the globe revealed no acanthamoeba cysts or trophozoites at the site of crotherapy.


CONCLUSIONS
Our study provides evidence for the invasion of acanthamoeba organisms into the sclera in a case of acanthamoeba keratitis. The presence of trophozites in scleral tissue may exacerbate the immune response leading to nodular scleritis.
Eye Pathology Laboratory and Cornea/External Disease Service, Wilmer Eye Institute and Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Katayoon B
KB
Ebrahimi
W Richard
WR
Green
Rhonda
R
Grebe
Albert S
AS
Jun
D000048:Acanthamoeba / Q000254:growth & development / Q000648:ultrastructure; D015823:Acanthamoeba Keratitis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D000328:Adult; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000977:Antiparasitic Agents / Q000627:therapeutic use; D003263:Contact Lenses, Hydrophilic; D017679:Cryotherapy; D005260:Female; D006801:Humans; D046529:Microscopy, Electron, Transmission; D012590:Sclera / Q000473:pathology / Q000648:ultrastructure; D015423:Scleritis / Q000469:parasitology* / Q000473:pathology* / Q000628:therapy; D053058:Trophozoites / Q000648:ultrastructure
D000893:Anti-Inflammatory Agents; D000977:Antiparasitic Agents