How should Acanthamoeba scleritis be treated?

summary

Acanthamoebal scleritis is a kind of scleritis caused by Acanthamoeba protozoa. Serious threat to vision, long course of disease, chronic progressive scleral damage. How should Acanthamoeba scleritis be treated?

How should Acanthamoeba scleritis be treated?

Treatment methods: the treatment of Acanthamoeba keratoscleritis is still controversial. Acanthamoeba exists in two states: cyst and trophozoite, which need long-term treatment. The treatment includes 0.1% exelbromopropamidine, neomycin polymyxin and topical 1% miconazole eye drops or ointment. The frequency of treatment is first reduced and then reduced. The course of treatment is more than 4 weeks, plus oral ketoconazole and itraconazole.

In some cases, topical use of glucocorticoids is helpful to the regression of inflammation. However, it is still controversial whether Acanthamoeba scleritis is an absolute indication; Second, it can make the capsule resistant to amoeba

Acanthamoebal scleritis is diffuse or nodular, which can develop into necrotizing anterior scleritis and lead to scleral staphyloma. In the early stage of the disease, there were redness, photophobia, tears, foreign body sensation, conjunctival sac secretion, eye pain, and decreased vision. More than 50% of the patients had severe eye pain, severe at night, and radiated to the trigeminal nerve branch. The prognosis of diffuse anterior scleritis is relatively good, the sclera is diffuse hyperemia, bulbar conjunctival edema, the lesion is easy to spread, the scope of the lesion is limited accounted for about 60%.

matters needing attention

Because acanthamoebal scleritis is rare and often misdiagnosed, it is difficult to confirm the diagnosis even if Acanthamoeba scleral infection is considered first. Detailed medical history, slit lamp examination, special staining of smear or biopsy tissue and cultivation with E. coli nutrient free medium can make early diagnosis.