View More View Less
  • 1 Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Általános Orvostudományi Kar Szemészeti Klinika Debrecen Nagyerdei krt. 98. 4032
Restricted access

Purchase article

USD  $25.00

1 year subscription (Individual Only)

USD  $1,070.00

Az Acanthamoeba-infekciók száma világszerte, így hazánkban is növekvő tendenciát mutat. A diagnosztikus és terápiás lehetőségek bővülése ellenére ez a betegség súlyosan károsíthatja a látást. A kórkép jellemzőit foglaljuk össze és mutatjuk be. A betegség elsősorban kontaktlencsét viselőkön alakul ki a nem megfelelő higiénia miatt. Szubjektív tünetei a fájdalom, vörös szem, könnyezés és szemhéjduzzanat. A klinikai képben jellegzetes a gyűrű alakú cornea stromájába terjedő infiltrátum. Differenciáldiagnosztikai szempontból a bakteriális, gombás és herpeses keratitistől kell elkülöníteni. Diagnózisában, a részletes anamnézis mellett, elsősorban konfokális corneamikroszkópia és speciális mikrobiológiai vizsgálatok javasoltak. A kórkép kezelésére többféle konzervatív és sebészi terápia létezik. Az eredményes gyógyuláshoz időben történő felismerés és hosszan tartó adekvát terápia szükséges. A legfontosabb azonban a megelőzés, amely az illesztők feladata, a páciensek felvilágosítása a megfelelő higiénés szabályok betartásáról, a korszerű lencsék és ápolószerek használatáról.

  • Stehr-Green, J. K., Bailey, T. M., Visvesvara, G. S.: The epidemiology of Acanthamoeba keratitis in the United States. Am. J. Ophtalmol., 1989, 107 , 331–336.

    Visvesvara G. S. , 'The epidemiology of Acanthamoeba keratitis in the United States ' (1989 ) 107 Am. J. Ophtalmol. : 331 -336.

    • Search Google Scholar
  • Radford, C. F., Bacon, A. S., Dart, J. K. és mtsa: Risk factors for Acanthamoeba keratitis contact lens users: a case-control study. BMJ, 1995, 310 , 1567–1570.

    Dart J. K. , 'Risk factors for Acanthamoeba keratitis contact lens users: a case-control study ' (1995 ) 310 BMJ : 1567 -1570.

    • Search Google Scholar
  • Radford, C. F., Lehmann, O. J., Dart, J. K.: Acanthamoeba keratitis: multicentre survey in England 1992–96. Br. J. Ophtalmol., 1998, 82 , 1387–1392.

    Dart J. K. , 'Acanthamoeba keratitis: multicentre survey in England 1992–96 ' (1998 ) 82 Br. J. Ophtalmol. : 1387 -1392.

    • Search Google Scholar
  • Radford, C. F., Minassian, D. C., Dart, J. K.: Acanthamoeba keratitis in England and Wales: incidence, outcome, and risk factors. Br. J. Ophtalmol., 2002, 86 , 536–542.

    Dart J. K. , 'Acanthamoeba keratitis in England and Wales: incidence, outcome, and risk factors ' (2002 ) 86 Br. J. Ophtalmol. : 536 -542.

    • Search Google Scholar
  • Marciano-Cabral, F., Cabral, G.: Acanthamoeba ssp. as agent of disease in humans. Clin. Microbiol. Rev., 2003, 16 , 273–307.

    Cabral G. , 'Acanthamoeba ssp. as agent of disease in humans ' (2003 ) 16 Clin. Microbiol. Rev. : 273 -307.

    • Search Google Scholar
  • Dunand, V. A., Hammer, S. M., Rossi, R. és mtsai: Parasitic sinusitis and otitis in patients infected with human immunodeficiency virus: report of five cases and review. Clin. Infect. Dis., 1997, 25 , 267–272.

    Rossi R. , 'Parasitic sinusitis and otitis in patients infected with human immunodeficiency virus: report of five cases and review ' (1997 ) 25 Clin. Infect. Dis. : 267 -272.

    • Search Google Scholar
  • Gullett, J., Mills, J., Hadley, K. és mtsai: Disseminated granulomatosus Acanthamoeba infection presenting as an unusual skin lesion. Am. J. Med., 1979, 67 , 891–896.

    Hadley K. , 'Disseminated granulomatosus Acanthamoeba infection presenting as an unusual skin lesion ' (1979 ) 67 Am. J. Med. : 891 -896.

    • Search Google Scholar
  • Illingworth, C. D., Cook, S. D.: Acanthamoeba keratitis. Surv. Ophtalmol., 1998, 42 , 493–508.

    Cook S. D. , 'Acanthamoeba keratitis ' (1998 ) 42 Surv. Ophtalmol. : 493 -508.

  • Jones, B. R., Visvesvara, G. S., Robinson, N. M.: Acanthamoeba polyphaga keratitis and Acanthamoeba uveitis associated with fatal meningoencephalitis. Trans. Ophtalmol. Soc. UK, 1975, 95 , 221–232.

    Robinson N. M. , 'Acanthamoeba polyphaga keratitis and Acanthamoeba uveitis associated with fatal meningoencephalitis ' (1975 ) 95 Trans. Ophtalmol. Soc. UK : 221 -232.

    • Search Google Scholar
  • Martinez, A. J., Guerra, A. E., Garcia Tamayo, J. és mtsai: Granulomatosus amoebic encephalitis: a review and report of a spontaneous case from Venezuela. Acta Neuropathol., 1994, 87 , 430–434.

    Garcia Tamayo J. , 'Granulomatosus amoebic encephalitis: a review and report of a spontaneous case from Venezuela ' (1994 ) 87 Acta Neuropathol. : 430 -434.

    • Search Google Scholar
  • Gray, T. B., Curson, R. T. M., Sherwarn, J. F. és mtsa: Acanthamoeba, bacterial, and fungal contamination of contact lens storage cases. Br. J. Ophtalmol., 1995, 79 , 601–605.

    Sherwarn J. F. , 'Acanthamoeba, bacterial, and fungal contamination of contact lens storage cases ' (1995 ) 79 Br. J. Ophtalmol. : 601 -605.

    • Search Google Scholar
  • Kilvington, S., Gray, T., Dart, J. és mtsai: Acanthamoeba keratitis: The role of domestic tap water contamination in the United Kingdom. Invest. Ophtalmol. Vis. Sci., 2004, 45 , 165–169.

    Dart J. , 'Acanthamoeba keratitis: The role of domestic tap water contamination in the United Kingdom ' (2004 ) 45 Invest. Ophtalmol. Vis. Sci. : 165 -169.

    • Search Google Scholar
  • Khan, N. A.: Pathogenicity, morphology, and differentation of Acanthamoeba. Curr. Microbiol., 2001, 43 , 391–395.

    Khan N. A. , 'Pathogenicity, morphology, and differentation of Acanthamoeba ' (2001 ) 43 Curr. Microbiol. : 391 -395.

    • Search Google Scholar
  • Clarke, D. W., Niederkorn, J.: The pathophysiology of Acanthamoeba keratitis. Trends Parasitol., 2006, 22 , 175–180.

    Niederkorn J. , 'The pathophysiology of Acanthamoeba keratitis ' (2006 ) 22 Trends Parasitol. : 175 -180.

    • Search Google Scholar
  • Hurt, M., Niederkorn, J., Alizadeh, H.: Effects of mannose on Acanthamoeba castellanii proliferation and cytolytic ability to corneal epithelial cells. Invest. Ophthalmol. Vis. Sci., 2003, 44 , 3424–3431.

    Alizadeh H. , 'Effects of mannose on Acanthamoeba castellanii proliferation and cytolytic ability to corneal epithelial cells ' (2003 ) 44 Invest. Ophthalmol. Vis. Sci. : 3424 -3431.

    • Search Google Scholar
  • Nwachuku, N., Gerba, C. P.: Health effects of Acanthamoeba spp. and its potential for waterborne transmission. Rev. Environ. Contam. Toxicol., 2004, 180 , 93–191.

    Gerba C. P. , 'Health effects of Acanthamoeba spp. and its potential for waterborne transmission ' (2004 ) 180 Rev. Environ. Contam. Toxicol. : 93 -191.

    • Search Google Scholar
  • Nagington, J., Watson, P. G., Playfair, T. J. és mtsai: Amoebic infection of the eye. Lancet, 1974, 28 , 1537–1540.

    Playfair T. J. , 'Amoebic infection of the eye ' (1974 ) 28 Lancet : 1537 -1540.

  • Seal, D. V.: Acanthamoeba keratitis update-incidence, molecular epidemiology and new drugs for treatment. Eye, 2003, 17 , 893–905.

    Seal D. V. , 'Acanthamoeba keratitis update-incidence, molecular epidemiology and new drugs for treatment ' (2003 ) 17 Eye : 893 -905.

    • Search Google Scholar
  • Chynn, E. W., Lopez, M. A., Pavan-Langston, D. és mtsa: Acanthamoeba keratitis. Contact lens and noncontact lens characteristic. Ophtalmology, 1995, 102 , 1369–1373.

    Pavan-Langston D. , 'Acanthamoeba keratitis. Contact lens and noncontact lens characteristic ' (1995 ) 102 Ophtalmology : 1369 -1373.

    • Search Google Scholar
  • Sharma, S., Garg, P., Rao, G. N.: Patient characteristics, diagnosis, and treatment of non-contact lens releated Acanthamoeba keratitis. Br. J. Ophtalmol., 2000, 84 , 1103–1108.

    Rao G. N. , 'Patient characteristics, diagnosis, and treatment of non-contact lens releated Acanthamoeba keratitis ' (2000 ) 84 Br. J. Ophtalmol. : 1103 -1108.

    • Search Google Scholar
  • Seal, D. V., Kirkness, C. M., Bennett, H. G. B. és mtsai, Keratitis Study Group: Acanthamoeba keratitis in Scotland: risk factors for contact lens wearers. Contact Lens Anter. Eye, 1999, 22 , 58–68.

    Bennett H. G. B. , 'Acanthamoeba keratitis in Scotland: risk factors for contact lens wearers. Contact Lens Anter ' (1999 ) 22 Eye : 58 -68.

    • Search Google Scholar
  • Dejaco-Ruhswurm, I., Scholz, U., Hanselmayer, G. és mtsa: Contact lens induced keratitis associated with contact lens wear. Acta Ophtalmol. Scand., 2001, 79 , 479–483.

    Hanselmayer G. , 'Contact lens induced keratitis associated with contact lens wear ' (2001 ) 79 Acta Ophtalmol. Scand. : 479 -483.

    • Search Google Scholar
  • Beattie, T. K., Tomlinson, A., McFadyen, A. K. és mtsai: Enhanced attachment of Acanthamoeba to extended-wear silicone hydrogel contact lenses. Ophtalmology, 2003, 110 , 765–771.

    McFadyen A. K. , 'Enhanced attachment of Acanthamoeba to extended-wear silicone hydrogel contact lenses ' (2003 ) 110 Ophtalmology : 765 -771.

    • Search Google Scholar
  • Lema, I., Rodríguez-Ares, M. T., Gómez-Torreiro, M. és mtsa: Adherence of Acanthamoeba to unworn conventional and disposable soft contact lenses. Cornea, 2001, 20 , 635–638.

    Gómez-Torreiro M. , 'Adherence of Acanthamoeba to unworn conventional and disposable soft contact lenses ' (2001 ) 20 Cornea : 635 -638.

    • Search Google Scholar
  • Beattie, T. K., Tomlinson, A., McFadyen, A. K.: Attachment of Acanthamoeba to first- and second-generation silicone hydrogel contact lenses. Ophtalmology, 2006, 113 , 117–125.

    McFadyen A. K. , 'Attachment of Acanthamoeba to first- and second-generation silicone hydrogel contact lenses ' (2006 ) 113 Ophtalmology : 117 -125.

    • Search Google Scholar
  • Kilvington, S.: Acanthamoeba trophozoite and cyst adherence to four types of soft contact lens and removal by cleaning agents. Eye, 1993, 7 , 535–538.

    Kilvington S. , 'Acanthamoeba trophozoite and cyst adherence to four types of soft contact lens and removal by cleaning agents ' (1993 ) 7 Eye : 535 -538.

    • Search Google Scholar
  • Reinhard, T., Sundmacher, R.: Klinik und Therapie der Akantamöbenkeratitis. Ophtalmologie, 2000, 97 , 446–459.

    Sundmacher R. , 'Klinik und Therapie der Akantamöbenkeratitis ' (2000 ) 97 Ophtalmologie : 446 -459.

    • Search Google Scholar
  • Imre L., Tóth J., Megyesi M. és mtsai: Az Acanthamoeba keratitis in vivo diagnosztikája konfokális korneamikroszkóppal. Szemészet, 2004, 141 , 359–363.

    Megyesi M. , 'Az Acanthamoeba keratitis in vivo diagnosztikája konfokális korneamikroszkóppal ' (2004 ) 141 Szemészet : 359 -363.

    • Search Google Scholar
  • Hahn, T. W., O’Brien, T. P., Sah, W. J. és mtsa: Acridine orange staining for rapid diagnosis of Acanthamoeba keratitis. Jpn. J. Ophtalmol., 1998, 42 , 108–114.

    Sah W. J. , 'Acridine orange staining for rapid diagnosis of Acanthamoeba keratitis ' (1998 ) 42 Jpn. J. Ophtalmol. : 108 -114.

    • Search Google Scholar
  • Khan, N. A., Jarroll, E. L., Paget, T. A.: Acanthamoeba can be differentiated by the polymerase chain reaction and simple planting assay. Curr. Microbiol., 2001, 43 , 204–208.

    Paget T. A. , 'Acanthamoeba can be differentiated by the polymerase chain reaction and simple planting assay ' (2001 ) 43 Curr. Microbiol. : 204 -208.

    • Search Google Scholar
  • Hiti, K., Walochnik, J., Haller-Schober, E. M. és mtsai: Viability of Acanthamoeba after exposure to a multipurpose disinfecting contact lens solution and two hydrogen peroxyde systems. Br. J. Ophtalmol., 2002, 86 , 144–146.

    Haller-Schober E. M. , 'Viability of Acanthamoeba after exposure to a multipurpose disinfecting contact lens solution and two hydrogen peroxyde systems ' (2002 ) 86 Br. J. Ophtalmol. : 144 -146.

    • Search Google Scholar
  • Hiti, K., Walochnik, J., Faschinger, C. és mtsai: One- and two-step hydrogen peroxide contact lens disinfection solutions against Acanthamoeba: How effective are they? Eye, 2005, 19 , 1301–1305.

    Faschinger C. , 'One- and two-step hydrogen peroxide contact lens disinfection solutions against Acanthamoeba: How effective are they? ' (2005 ) 19 Eye : 1301 -1305.

    • Search Google Scholar
  • Niszl, I. A., Markus, M. B.: Anti-Acanthamoeba activity of contact lens solutions. Br. J. Ophtalmol., 1998, 82 , 1033–1038.

    Markus M. B. , 'Anti-Acanthamoeba activity of contact lens solutions ' (1998 ) 82 Br. J. Ophtalmol. : 1033 -1038.

    • Search Google Scholar
  • Borazjani, R. N., Kilvington, S.: Efficacy of multipurpose solution against Acanthamoeba species. Contact Lens Anter. Eye, 2005, 28 , 169–175.

    Kilvington S. , 'Efficacy of multipurpose solution against Acanthamoeba species. Contact Lens Anter ' (2005 ) 28 Eye : 169 -175.

    • Search Google Scholar
  • Hiti, K., Walochnik, J., Faschinger, C. és mtsai: Microwave treatment of contact lens cases contaminated with Acanthamoeba. Cornea, 2001, 20 , 467–470.

    Faschinger C. , 'Microwave treatment of contact lens cases contaminated with Acanthamoeba ' (2001 ) 20 Cornea : 467 -470.

    • Search Google Scholar
  • Walochnik, J. A., Duchene, M., Eibl, H. és mtsai: Die Behandlung der Acanthamoeba-Keratitis: Möglichkeiten, Probleme und neue Wege. Wien. Klin. Wochenschr., 2003, 115 , 10–17.

    Eibl H. , 'Die Behandlung der Acanthamoeba-Keratitis: Möglichkeiten, Probleme und neue Wege ' (2003 ) 115 Wien. Klin. Wochenschr. : 10 -17.

    • Search Google Scholar
  • Bacon, A. S., Frazer, D. G., Dart, J. K. G. és mtsai: A review of 72 consecutive cases of Acanthamoeba keratitis, 1984–1992. Eye, 1993, 7 , 719–725.

    Dart J. K. G. , 'A review of 72 consecutive cases of Acanthamoeba keratitis, 1984–1992 ' (1993 ) 7 Eye : 719 -725.

    • Search Google Scholar
  • Narasimhan, S., Madhavan, H. N., Therese, K. L.: Development and application of an in vitro susceptibility test for Acanthamoeba species isolated from keratitis to polyhexamethilene biguanide and chlorhexidine. Cornea, 2002, 21 , 203–205.

    Therese K. L. , 'Development and application of an in vitro susceptibility test for Acanthamoeba species isolated from keratitis to polyhexamethilene biguanide and chlorhexidine ' (2002 ) 21 Cornea : 203 -205.

    • Search Google Scholar
  • Ficker, L. A., Kirkness, C., Wright, P.: Prognosis for keratoplasty in Acanthamoeba keratitis. Ophtalmology, 1993, 100 , 105–110.

    Wright P. , 'Prognosis for keratoplasty in Acanthamoeba keratitis ' (1993 ) 100 Ophtalmology : 105 -110.

    • Search Google Scholar
  • Illingworth, C. D., Cook, S. D., Karabatsas, C. H. és mtsa: Acanthamoeba keratitis risk factor and outcome. Br. J. Ophtalmol., 1995, 79 , 1078–1082.

    Karabatsas C. H. , 'Acanthamoeba keratitis risk factor and outcome ' (1995 ) 79 Br. J. Ophtalmol. : 1078 -1082.

    • Search Google Scholar
  • McClellan, K., Howard, K., Niederkorn, J. és mtsa: Effect of steroid on Acanthamoeba cyst and trophosoites. Invest. Ophtalmol. Vis. Sci., 2001, 42 , 2885–2893.

    Niederkorn J. , 'Effect of steroid on Acanthamoeba cyst and trophosoites ' (2001 ) 42 Invest. Ophtalmol. Vis. Sci. : 2885 -2893.

    • Search Google Scholar
  • Amoils, S. P., Heney, C.: Acanthamoeba keratitis with live isolates treated with cryosurgery and Fluconazole. Am. J. Ophtalmol., 1999, 127 , 718–720.

    Heney C. , 'Acanthamoeba keratitis with live isolates treated with cryosurgery and Fluconazole ' (1999 ) 127 Am. J. Ophtalmol. : 718 -720.

    • Search Google Scholar
  • Cremon, G., Carrasc, M. A., Tytiu, A. és mtsa: Treatment of advanced Acanthamoeba keratitis with deep lamellar keratectomy and conjunctival flap. Cornea, 2002, 21 , 705–708.

    Tytiu A. , 'Treatment of advanced Acanthamoeba keratitis with deep lamellar keratectomy and conjunctival flap ' (2002 ) 21 Cornea : 705 -708.

    • Search Google Scholar
  • Kim, J. S., Kim, J. C., Na, B. K. és mtsai: Amniotic membrane patching promotes healing and inhibits proteinase activity on wound healing following acute corneal alkali burn. Exp. Eye. Res., 2000, 70 , 329–337.

    Na B. K. , 'Amniotic membrane patching promotes healing and inhibits proteinase activity on wound healing following acute corneal alkali burn ' (2000 ) 70 Exp. Eye. Res. : 329 -337.

    • Search Google Scholar
  • Süveges I., Tóth J., Bausz M. és mtsai: Keratoplasztika Acanthamoeba által okozott keratitisekben. Szemészet, 2001, 138 , 179–183.

    Bausz M. , 'Keratoplasztika Acanthamoeba által okozott keratitisekben ' (2001 ) 138 Szemészet : 179 -183.

    • Search Google Scholar