[Characteristic appearance of early-stage Acanthamoeba keratitis].
OBJECTIVE
To clarify the characteristic appearances of early-stage Acanthamoeba keratitis (AK) and to investigate the effects of topical steroids on those appearances.


METHODS
This study involved 25 eyes of 24 patients diagnosed as early-stage AK at Kyoto Prefectural University of Medicine between October 2002 and June 2008. All patients were contact lens wearers, and 23 patients (96%) were referred from other hospitals. Clinical findings in the medical records of all patients were analyzed retrospectively.


RESULTS
Radial keratoneuritis was observed in 20 of 25 eyes (80%), and pseudodendritic lesions were observed in 15 eyes (60%). Only 1 eye (4%) showed neither of these two findings. Of the 10 eyes treated with topical steroids until the first presentation at our hospital, 6 eyes manifested radial keratoneuritis and/or pseudodendritic lesions after the discontinuation of that treatment. The visual prognosis was good in both groups, with or without topical steroid treatment.


CONCLUSIONS
We found that radial keratoneuritis and pseudodendritic lesions are characteristic appearances of early-stage AK, and that topical steroid treatment might mask these characteristic findings.
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan. mihosasaki550317@yahoo.co.jp
Miho
M
Sasaki
Chie
C
Sotozono
Hidemi
H
Chihara
Mayumi
M
Ueta
Tsutomu
T
Inatomi
Norihiko
N
Yokoi
Tsunezou
T
Shiota
Shigeru
S
Kinoshita
D000048:Acanthamoeba / Q000302:isolation & purification; D015823:Acanthamoeba Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology / Q000473:pathology* / Q000503:physiopathology; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D001645:Biguanides / Q000008:administration & dosage; D003315:Cornea / Q000469:parasitology; D005260:Female; D006801:Humans; D008297:Male; D010866:Natamycin / Q000008:administration & dosage; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014785:Vision, Ocular; D055815:Young Adult
D000305:Adrenal Cortex Hormones; D001645:Biguanides; C031233:polihexanide; D010866:Natamycin