Posters

Acanthamoeba keratitis and role of confocal microscopy in this diagnosis: a clinical case

Poster Details

First Author: N.Marques PORTUGAL

Co Author(s):    A. Miranda   A. Cardoso   J. Cardoso   S. Barros   N. Donaire   N. Campos

Abstract Details

Purpose:

To elucidate the importance of signs in the accurate diagnosis of Acanthamoeba Keratitis and the follow-up of these patients

Setting:

Centro de Responsabilidade de Oftalmologia do hospital Garcia de Orta

Methods:

Clinical case, elaborated through the review of a clinical file, ophthalmological examination and analysis of ancillary tests.

Results:

26 years-old man, contact lenses user, was referred to our hospital with hyperemia of left eye (LE) without pain, diminished LE visual acuity (VA) with 1 month of evolution and medicated with topical dexamethasone, ganciclovir and levofloxacin without improvement. At clinical examination, the patient presented a LE VA of counting fingers near the face and 10/10 on the right eye (RE). The LE Biomicroscopy revealed a central cornea ulcer with coalescent stromal infiltrates, tyndal ++ without hypopyon. The bacteriological and micologycal cultures were negative and positive for Acanthamoeba. The confocal microscopy revealed a corneal inflammatory process associated with acanthamoeba cysts in epithelium and stroma. The patient was treated with chlorhexidine digluconate, propamidine, moxifloxacin and tropicamide. After 4 weeks of treatment, the patient showed a diminished ulcer with less stromal infiltrates, with tyndal+, without pain and a confocal microscopy with less and only central cysts with diminished inflammation.

Conclusions:

Acanthamoeba Keratitis is frequently associated with soft contact lenses wear and is an important cause of visual impairment worldwide. The early treatment is an important prognostic factor, being the confocal microscopy an important way to do the diagnosis. Confocal microscopy is a non - invasive exam, easy to do, that could show acanthamoeba cysts in epithelium and corneal stroma and the clinical progression of the disease. FINANCIAL INTEREST: NONE