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M. Ono, H. Tachibana, E. Hiwatashi, Y. Ishibashi, H. Yano, Y. Kaneda; Immunodiagnosis of Acanthamoeba Keratitis using Monoclonal Antibodies . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4758.
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Purpose: Acanthamoeba keratitis is a known cause of infectious keratitis which can lead to severe visual disturbances. Diagnosis is difficult during its early stages. For the detection of amoebae, KOH Parker ink is useful although this method has a very low specificity. Previously, we have elaborated fourteen monoclonal antibodies (mAbs) to Acanthamoeba castellanii (Hiwatashi 1997). This study was designed to evaluate the efficacy of immunodiagnoasis for acanthamoeba keratitis using mAbs. Methods: Three patients with prospectively diagnosed acanthamoeba keratitis were selected. All corneas had a ring infiltrate and were treated with topical 0.2% fluconazole and 0.1% miconazole. Material was obtained from patients by corneal scrapings at their first and second visits. The scrapings were immunofluorescein stained using mAbs prepared by Hiwatashi's (1997) method and cultured in peptone-yeast extract-glucose medium. Results: In the corneal scraping from one of the three patients, cysts 10µm in diameters were detected by the immunofluorescein staining. However, the cultures remained negative. From the shape of the cysts and the staining results, we were able to diagnose the Acanthamoeba castellanii keratitis. Conclusion: For the diagnosis of infectious keratitis, the corneal scrapings are important. Our results suggest that the immunodiagnosis by the use of monoclonal antibodies is useful for diagnosing Acanthamoeba keratitis from corneal scrapings.
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