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2005 OMIG, Abstract 11

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Acanthamoeba Keratitis Induced Retinal Ischemia

Shady T. Awwad, MD, Michelle Heilman, MD, Dipak Parmar, MD, James P. McCulley, MD, H. Dwight Cavanagh, MD, PhD

Purpose: To report 5 cases of Acanthamoeba keratitis that developed severe non-infectious posterior pole ischemia.

Methods: A retrospective chart review was performed on 94 patients diagnosed with Acanthamoeba keratitis by tandem scanning confocal comeal microscopy and/or comeal culture. Inclusion criteria included eyes with final vision ranging from no light perception to light perception without projection.

Results: 5 eyes of 5 patients had clinical blindness with an afferent pupillary defect and marked retinal ischemia seen on fundoscopy. Three out of the 5 patients had hematological testing, and they showed hypercoagulable states with elevated levels of antiphospholipid antibodies. Three patients underwent enucleation and histopatho logic examination showed evidence of retinal ischemia with perivascular lymphocytic infiltration. There were no Acanthamoeba trophozoites or cysts identified in the posterior segment.

Conclusions: Acanthamoeba keratitis can lead to severe posterior pole involvement that is unlikely to be infectious in nature. An Acanthamoeba keratitis induced hypercoagulable state might lead to retinal vascular occlusion and subsequent retinal ischemia.

Disclosure code: None

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