J Korean Ophthalmol Soc.  2019 Dec;60(12):1312-1317. 10.3341/jkos.2019.60.12.1312.

Diagnostic Utility of Polymerase Chain Reaction for Acanthamoeba in Contact Lens-related Keratitis with Epithelial Defects

• Kang MC
• Lim DH
• Huh HJ
• Yoo IY
• Chung TY

• KMID: 2466188
• DOI: http://doi.org/10.3341/jkos.2019.60.12.1312

Abstract

PURPOSE
To report contact lens related Acanthamoeba keratitis with corneal epithelial defect cases which were diagnosed using polymerase chain reaction (PCR).
CASE SUMMARY
A 51-year-old male visited our hospital for loss of visual acuity and ocular pain in both eyes. He had been wearing therapeutic contact lenses in both eyes for 4 days prior to his visit, and showed a corneal epithelial defect with corneal edema in both eyes. The corneal edema did not improve after treatment for bacterial and herpes keratitis, so we conducted PCR for Acanthamoeba using the aqueous fluid in the anterior chamber, which showed positive results. A 32-year-old male complained of low visual acuity and ocular pain in both eyes. He had a history of corneal erosion. He had been wearing therapeutic contact lenses in both eyes for 3 days prior to his visit for a corneal epithelial defect. We suspected recurrent corneal erosion syndrome, but PCR for Acanthamoeba of the corneal scraping showed positive results. A 26-year-old female visited our hospital for ocular pain, and discomfort in her left eye. Because of severe dry eye, she had been wearing therapeutic contact lenses for 6 weeks prior to her visit. Her left eye showed corneal infiltration and epithelial defects. The left cornea scraping was positive for bacteria, and PCR for Acanthamoeba also showed positive results.
CONCLUSIONS
Clinicians should consider the use of PCR for the early diagnosis of Acanthamoeba keratitis in contact lens-related keratitis with corneal epithelial defects.

Keyword

Acanthamoeba keratitis; Contact lenses; Epithelial defect; Polymerase chain reaction

MeSH Terms

Acanthamoeba Keratitis
Acanthamoeba*
Adult
Anterior Chamber
Bacteria
Contact Lenses
Cornea
Corneal Edema
Early Diagnosis
Female
Humans
Keratitis*
Male
Middle Aged
Polymerase Chain Reaction*
Visual Acuity