2005
OMIG, Abstract 11
OMIG
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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
OMIG
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