Acanthamoeba keratitis: a challenge in diagnosis and the role of amniotic membrane transplant as an alternative therapy

Medical Journal of Indonesia

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Field Value
 
Title Acanthamoeba keratitis: a challenge in diagnosis and the role of amniotic membrane transplant as an alternative therapy
 
Creator Muslim, Fitri; Department of Ophthalmology, Faculty of Medicine, University of Indonesia, Jakarta
Sitompul, Ratna; Department of Ophthalmology, Faculty of Medicine, University of Indonesia, Jakarta
Edwar, Lukman; Department of Ophthalmology, Faculty of Medicine, University of Indonesia, Jakarta
 
Subject Acanthamoeba keratitis; amniotic membrane transplantation; propamidine isethionate
 
Description Acanthamoeba keratitis (AK) is a very rare, sight-threatening corneal disease caused by the infection of a free-living amoeba. The aim of this report was to demonstrate the challenges in the diagnosis of AK with an atypical presentation. Amniotic membrane transplantation (AMT) was done in this case to accelerate wound healing. A woman who frequently used contact lens came with redness and a whitish spot in her left eye 2 weeks before admission. There was a history of rinsing contact lens in tap water. The patient had already been on a topical steroid for 2 weeks. Visual acuity of the left eye was light perception with wrong projection. Examination of the left cornea showed a semi-circular central ulcer with a 5.8-mm area and 1/3 stromal depth. It is surrounded by a feathery-edge infiltrate with positive satellite lesions but without hypopyon. It was diagnosed as corneal ulcers due to mixed infection (bacteria and fungi). After 2 weeks of bacterial and fungal therapy, the size of the ulcer decreased, but the corneal infiltrate remained; therefore, an Acanthamoeba culture was done to determine the possibility of Acanthamoeba infection. Two weeks after the Acanthamoeba topical therapy, the visual acuity improved. AMT was performed to accelerate wound healing. Two months post-AMT, visual acuity improved to 1/60 with no conjunctival or ciliary vasodilation, and the ulcer was resolved. The patient was planned to undergo keratoplasty. The diagnosis of AK with an atypical presentation is challenging. AMT can be used as an alternative therapy to accelerate wound healing.
 
Publisher Faculty of Medicine Universitas Indonesia
 
Contributor N/A
 
Date 2018-12-31
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion

 
Format application/pdf
 
Identifier http://mji.ui.ac.id/journal/index.php/mji/article/view/2007
10.13181/mji.v27i4.2007
 
Source Medical Journal of Indonesia; Vol 27, No 4 (2018): December; 299-303
2252-8083
0853-1773
10.13181/mji.v27i4
 
Language eng
 
Relation http://mji.ui.ac.id/journal/index.php/mji/article/view/2007/1254
 
Rights Copyright (c) 2018 Fitri Muslim, Ratna Sitompul, Lukman Edwar
http://creativecommons.org/licenses/by-nc/4.0
 

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