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Bowman's layer encystment in cases of persistent Acanthamoeba keratitis
Hideaki Yokogawa1, Akira Kobayashi, Natsuko Yamazaki
1Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa.
Clinical Ophthalmology (Auckland, N.Z.)
|August 29, 2012
Summary
Acanthamoeba keratitis (AK) cysts invading Bowman's layer predict a persistent disease course. This finding aids in predicting AK persistence in Japanese patients.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Investigating Acanthamoeba encystment in Bowman's layer in Japanese persistent Acanthamoeba keratitis (AK) cases.
- Understanding the pathogenesis and clinical course of AK.
Observation:
- In vivo confocal microscopy of 18 eyes from 17 AK patients.
- Categorization into nonpersistent (≤4 months) and persistent (>6 months) treatment groups.
- Qualitative evaluation of corneal confocal images for Acanthamoeba cysts.
Findings:
- Persistent AK group showed significantly lower best-corrected visual acuity.
- Initially, Acanthamoeba cysts were in the epithelial layer in both groups.
- In persistent AK, cysts later appeared in Bowman's layer and epithelial cells.
Implications:
- Acanthamoeba cyst invasion into Bowman's layer is characteristic of persistent AK.
- This invasion may serve as a predictive marker for a prolonged AK clinical course.
- Highlights the importance of Bowman's layer involvement in AK pathogenesis.
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