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N. Fayol, T. Bourcier, B. Dupas, V. Borderie, C. Chaumeil, P. Larricart, C. Baudouin, L. Laroche; Heidelberg Retina Tomograph II Findings of Acanthamoeba Keratitis . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2612.
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Purpose: Acanthamoeba Keratitis (AK) is a painful, potentially blinding condition that, like any infectious keratitis, benefits from early detection and treatment. Heidelberg Retina Tomograph II (HRTII) (Heidelberg engineering, Dossenheim, Germany) examination was performed with cornea module in one patient with AK to provide images detailing characteristic findings of the disease. Methods: A 34–year–old woman presented with clinical signs and symptoms of AK. HRTII with cornea module was performed. Pictures were taken from all corneal structures of the central and peripheral cornea and compared to those of healthy subjects. The patient underwent laboratory investigations. Results: HRTII examination with cornea module revealed numerous 20 to 26 µm diameter high–contrast round particles within the corneal epithelium and anterior stroma, resembling acanthamoeba cysts. Morphologic details of these cyst–like particles suggested the presence of a double wall. Stellate cells as well as ovoid irregular objects, possibly inflammatory cells, trophozoites, altered cysts, or activated keratocytes, were also present in the area of stromal infiltrates. An irregularly thickened stromal nerve was seen, consistent with radial keratoneuritis. Confirmation of AK was obtained by cytological examination of corneal smears which revealed the presence of numerous acanthamoeba cysts. Conclusions: HRTII cornea module provides non–invasive, high–contrast, in vivo images of the cornea. It can be helpful in the diagnosis of AK by identifying acanthamoeba cyst–like structures in the cornea. This technique has also potential uses in monitoring the efficiency of anti–infective treatment.
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