title: In vivo imaging of radial keratoneuritis in patients with Acanthamoeba keratitis by anterior-segment optical coherence tomography.
abstract: OBJECTIVE
  To investigate in vivo corneal changes of radial keratoneuritis in early-stage Acanthamoeba keratitis (AK) using anterior-segment optical coherence tomography (AS-OCT).
  
  
  METHODS
  Single-center, prospective clinical study.
  
  
  METHODS
  Four eyes (4 patients with a mean age of 28.5 years) with early-stage AK showing radial keratoneuritis were included in this study. Definitive diagnosis was made by confirmation of AK cysts using in vivo confocal microscopy and culture.
  
  
  METHODS
  Anterior-segment OCT examination was performed on the initial visit and at follow-up visits paying special attention to radial keratoneuritis.
  
  
  METHODS
  Selected AS-OCT images of the cornea were evaluated qualitatively for the shape and degree of light reflection of abnormal neurons.
  
  
  RESULTS
  With the use of AS-OCT, we successfully obtained high-resolution images of putative radial keratoneuritis in all patients as highly reflective bands or lines in the corneal stroma. The depth and width of the highly reflective bands/lines varied from case to case (anterior stroma to mid-stroma, from 20 to 200 μm). Some lines ran obliquely from the deep peripheral stroma toward the anterior stroma, and some were located at different depths (subepithelial and mid-stroma) and ran relatively parallel to the corneal layers. After appropriate treatment, radial keratoneuritis was resolved by both slit-lamp biomicroscopy and AS-OCT in all patients.
  
  
  CONCLUSIONS
  High-resolution Fourier-domain AS-OCT provides novel and detailed visual information of radial keratoneuritis in patients with early-stage AK. Visualization of radial keratoneuritis by AS-OCT may be a useful adjunct to the diagnosis and follow-up of early-stage AK.
authors.affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Natsuko
authors.initials: N
authors.lastname: Yamazaki
authors.affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan. Electronic address: kobaya@kenroku.kanazawa-u.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Kobayashi
authors.affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yokogawa
authors.affiliation: Department of Ophthalmology, Tsukuba Hospital, Tsukuba, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Ishibashi
authors.affiliation: Department of Medical Zoology, Kanazawa Medical University, Kahoku, Japan.
authors.forename: Yosaburo
authors.initials: Y
authors.lastname: Oikawa
authors.affiliation: Department of Parasitology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Tokoro
authors.affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Sugiyama
mesh_terms: D015823:Acanthamoeba Keratitis / Q000175:diagnosis* / Q000188:drug therapy; D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D003263:Contact Lenses, Hydrophilic / Q000469:parasitology; D003315:Cornea / Q000294:innervation*; D003389:Cranial Nerve Diseases / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009443:Neuritis / Q000175:diagnosis* / Q000188:drug therapy; D009882:Ophthalmic Nerve / Q000473:pathology*; D011446:Prospective Studies; D012307:Risk Factors; D041623:Tomography, Optical Coherence; D055815:Young Adult
chemical_list: D000935:Antifungal Agents