Skip Navigation LinksHome > December 2013 - Volume 32 - Issue 12 > Scleral and Intraocular Amoebic Dissemination in Acanthamoeb...
doi: 10.1097/ICO.0b013e31829ded51
Case Report

Scleral and Intraocular Amoebic Dissemination in Acanthamoeba Keratitis

Arnalich-Montiel, Francisco MD, PhD*; Jaumandreu, Laia MD*; Leal, Marina MD*; Valladares, Basilio PhD; Lorenzo-Morales, Jacob PhD

Collapse Box


Purpose: To review an Acanthamoeba keratitis case series for the documented extracorneal spread of the amoeba.

Methods: A retrospective review of an observational case series from a single institution.

Results: Three patients with 4 instances of microbiologically confirmed extracorneal amoebic spread were identified. Patient 1 had nodular scleritis after undergoing penetrating keratoplasty and was treated successfully with double freeze–thaw cryotherapy; patient 2 had intraocular dissemination of the amoeba detected in a retrocorneal membrane; and patient 3 had, after undergoing tectonic keratoplasty, intraocular dissemination of the amoeba that was treated successfully with intraocular and systemic voriconazole and, afterwards, a nodular scleritis treated with double freeze–thaw cryotherapy and a large-diameter corneal graft to treat corneal recurrence.

Conclusions: Acanthamoeba can migrate to the sclera or to the intraocular tissues in some instances, such as in long-standing disease or in penetrating keratoplasty. A prompt biopsy for microbiological analysis and early treatment are required, if this is suspected. Voriconazole can be effective for intraocular invasion when used orally and intraocularly. Scleral involvement might require a surgical approach with double freeze–thaw cryotherapy to treat the localized disease.

© 2013 by Lippincott Williams & Wilkins.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.