Posters

Anterior segment optical coherence tomography in suspected Acanthamoeba keratitis

Poster Details

First Author: M.Bakkali el Bakkali SPAIN

Co Author(s):    A. Mateo Orobia   M. Idoipe Corta   M. Romero Sanz   B. Arias del Peso   M. Vicente Altabás   A. Sánchez Pérez-Borbujo     

Abstract Details

Purpose:

To show in vivo that Acanthamoeba radial keratoneuritis could be observed in early stages by anterior segment spectral domain optical coherence tomography (AS-SD-OCT) even before a clear finding at anterior segment slit lamp biomicroscopy.

Setting:

Ophthalmology department, cornea and ocular surface unit, Miguel Servet University Hospital, Zaragoza, Spain

Methods:

A 29-year-old healthy male, contact lens user, arrived to our department complaining about redness and foreign body sensation, without decreased visual acuity or other eye symptomatology. At the slit lamp examination, an epithelial punctiform defect, smoothly infiltrated, was visualized with bad response to topical antibiotics (after taking samples for microbiological culture). On subsequent explorations faded linear-like infiltrates appeared, after which topical propamidine 0.1% was added as treatment, due to a high suspect of Acanthamoeba infection. AS-SD-OCT was performed in order to elucidate findings that support suspicion, due to the negativity of the microbiological cultures.

Results:

High-resolution images of possible radial keratoneuritis were obtained, as hipereflective bands with a thickness of 80-90 µm near limbus, 40-50 µm in mid-periphery and 20-30 µm in paracentral cornea. Most of the lines were arranged in mid stroma running in a parallel way. In successive visits, definitive keratoneuritis was finally seen at anterior segment slit lamp examination, confirming AS-SD-OCT findings.

Conclusions:

Anterior segment optical coherence tomography is a useful, fast, reproducible, and contactless method, to support diagnosis and follow-up, specially in suspicious or early-stage Acanthamoeba Keratitis, in order to provide timely care and improve the visual prognosis of these patients.

Financial Disclosure:

None