Primary subretinal abscess caused by acanthamoeba: clinical and pathologic case report and review of the literature

To report the clinical and pathologic findings in a patient with a primary Acanthamoeba subretinal abscess.

A healthy 40-year-old man was evaluated and treated for a subretinal abscess. A subretinal aspirate was evaluated using hematoxylin-eosin stains and polymerase chain reaction.

Results of the histologic examination of the subretinal aspirate demonstrated numerous Acanthamoeba cysts. The diagnosis was confirmed by polymerase chain reaction. The infection was treated with local and systemic antimicrobials. The visual acuity remained stable, and there was no local or systemic spread of the infection.

To the authors' knowledge, this is the first biopsy-proven case of primary subretinal abscess because of Acanthamoeba. Acanthamoeba should be considered in the differential diagnosis of a subretinal abscess, even in the absence of systemic or corneal symptoms. Aggressive treatment can prevent serious ocular and systemic complications.