初期と完成期のアカントアメーバ角膜炎の2例 (眼科学教室 堀貞夫教授退任記念特別号)  [in Japanese] Two Cases of Acanthamoeba Keratitis Early Stage and Advanced Stage  [in Japanese]

Access this Article

Author(s)

Abstract

アカントアメーバ角膜炎の初期例と完成期例の2例を経験したので報告する。,症例1は22歳、男性。1カ月定期交換のソフトコンタクトレンズ装用者だった。左眼,痛と充血を主訴に、発症から3週間後に当院を受診した。初診時、毛様充血、放射状角膜神経炎と偽樹枝状角膜炎を認め、初期のアカントアメーバ角膜炎と診断し、角膜擦過、消毒薬点眼、抗真菌薬の局所・全身投与を施行した。3カ月後、視力(1.2)と視力障害を残さず治癒した。,症例2は13歳、女性。2週間頻回交換ソフトコンタクトレンズ装用者。主訴は眼痛と充血で、当院受診までに2カ所の眼科診療所を受診し、抗菌薬、ステロイド薬の点眼治療を受けた。発症から4カ月後に当院初診。毛様充血、角膜中央から上方にかけて円板状の混濁を認めた。完成期のアカントアメーバ角膜炎と診断し、症例1と同様の加療を行った。4カ月後、炎症は沈静化したが、視力(0.4)と視力障害が残った。,ステロイド点眼の投与の有無が、初診時の病期の違いの要因の1つと思われた。また早期発見、早期治療の重要性があらためて示唆された。

Purpose: We report two cases of Acanthoamoeba keratitis; one case in the early stage and another case in the advanced stage.,Case reports: Case 1 was 22-year-old man wearing monthly disposable soft contact lenses, who complained of hyperemia and ocular pain in his left eye. He visited our clinic at three weeks after the onset. The corneal findings at the initial visit were ciliary hyperemia, radial keratoneuritis and pseudodendritic keratitis, and acanthamoeba keratitis was suspected. At 3 months after treatment by scratching the ulcer lesion, antibiotic and anti-fungal ophthalmic solutions and systemic antibiotic agents.,The corneal ulcer subsided with a good visual acuity of (1.2).,Case 2 was a 13-year-old adolescent wearing frequent replacement contact lenses (FRCL). She had complaints of hyperemia and ocular pain in her right eye, and visited, Two different clinics where antibiotic and steroid ophthalmic solutions were administered. At 4 months after the onset she visited our clinic as symptoms did not resolve.The corneal findings at the initial visit were ciliary hyperemia, penny-shaped, opacity of central corneal stroma, and we suspected the lesion was from acanthamoeba infection. Treatment was by a regimen similar to case 1, the corneal erosion subsided at 4 months after treatment, but the visual acuity remained in(0.4)the same. ,Conclusion: The initial treatment regimen with or without ophthalmic steroid solutions seemed to affect the stages of acanthamoeba keratitis, and the importance of early detection and treatment was recognized again.

Journal

  • Journal of Tokyo Women's Medical College

    Journal of Tokyo Women's Medical College 82(-), E249-253, 2012-01

    Tokyo Women's Medical University

Codes

  • NII Article ID (NAID)
    110008767986
  • NII NACSIS-CAT ID (NCID)
    AN00161368
  • Text Lang
    JPN
  • Article Type
    journal article
  • Journal Type
    大学紀要
  • ISSN
    0040-9022
  • NDL Article ID
    023518512
  • NDL Call No.
    Z19-400
  • Data Source
    NDL  NII-ELS  IR 
Page Top