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H. Shiota, M. Inoue, Y. Kubo, Y. Hayashi, H. Eguchi, T. Naitou; Best Classification of Acanthamoeba Keratitis . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2611.
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Purpose:Acanthamoeba keratitis is one of the most difficult ocular infections to treat. It is often misdiagnosed as herpetic keratitis or keratomycosis. Its clinical stages have not been properly classified yet. Therefore, the classification of Acanthamoeba keratitis was tried. Methods:Eight eyes of Acanthamoeba keratitis were carefully observed by slit–lamp along with the treatment. The classification of the disease was done by the clinical progression of our cases with due consideraton of literature. Results:Our 8 eyes showed common features in their clinical progression, starting from punctate keratitis or corneal erosion, forming ring ulcer or infiltrate and finally resulting in corneal opacity. One eye showed nodular scleritis with corneal ulcer. Conclusions:We propose the classification of Acanthamoeba keratitis into 5 stages: early(stage 1), growing(stage 2), established (stage 3), regression(stage 4a), perforated(stage 4b) and cicatrical(stage 5). Also it should be born in mind that the disease can start healing at any stage with proper medication and in rare occasions nodular scleriris is complicated.
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