Bowman’s layer encystment in cases of persistent Acanthamoeba keratitis

Hideaki Yokogawa,1 Akira Kobayashi,1 Natsuko Yamazaki,1 Yasuhisa Ishibashi,2 Yosaburo Oikawa,3 Masaharu Tokoro,4 Kazuhisa Sugiyama11Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, 2Department of Ophthalmology, East Washinomiya Hospital, Kuki, 3Departmen...

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Autores principales: Yokogawa H, Kobayashi A, Yamazaki N, Ishibashi Y, Oikawa Y, Tokoro M, Sugiyama K
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Publicado: Dove Medical Press 2012
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spelling oai:doaj.org-article:a8f74f5bf3a54f6788d466ac304888672021-12-02T06:49:30ZBowman’s layer encystment in cases of persistent Acanthamoeba keratitis1177-54671177-5483https://doaj.org/article/a8f74f5bf3a54f6788d466ac304888672012-08-01T00:00:00Zhttp://www.dovepress.com/bowmanrsquos-layer-encystment-in-cases-of-persistent-acanthamoeba-kera-a10595https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Hideaki Yokogawa,1 Akira Kobayashi,1 Natsuko Yamazaki,1 Yasuhisa Ishibashi,2 Yosaburo Oikawa,3 Masaharu Tokoro,4 Kazuhisa Sugiyama11Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, 2Department of Ophthalmology, East Washinomiya Hospital, Kuki, 3Department of Medical Zoology, Kanazawa Medical University, Kahoku, 4Department of Parasitology, Kanazawa University Graduate School of Medical Science, Kanazawa, JapanBackground: The purpose of this study was to report Acanthamoeba encystment in Bowman’s layer in Japanese cases of persistent Acanthamoeba keratitis (AK).Methods: Laser confocal microscopic images of the cornea were obtained in vivo from 18 consecutive eyes from 17 confirmed AK patients. Retrospectively, 14 cases treated over 4 months were categorized as a nonpersistent group and three cases that required prolonged therapy for more than 6 months were categorized as a persistent group. Clinical outcomes based on final best-corrected visual acuity were retrospectively analyzed, and selected confocal images were evaluated qualitatively for abnormal findings.Results: The final best-corrected visual acuity was significantly lower (P < 0.01) for patients in the persistent group compared with that in the nonpersistent group. At the initial visit, in vivo confocal microscopy demonstrated Acanthamoeba cysts exclusively in the epithelial layer in both the nonpersistent group (80%) and the persistent group (100%). At a subsequent follow-up visit, numerous Acanthamoeba cysts were observed in the epithelial cell layer and in Bowman’s layer in all patients with persistent AK, but Acanthamoeba cysts were undetectable in all cases with nonpersistent AK tested.Conclusion: Invasion of cysts into Bowman’s layer was characteristically observed in patients with persistence of AK. This finding suggests that invasion of Acanthamoeba cysts into Bowman’s layer may be a useful predictor for a persistent clinical course.Keywords: Acanthamoeba keratitis, Bowman’s layer, encystmentYokogawa HKobayashi AYamazaki NIshibashi YOikawa YTokoro MSugiyama KDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 1245-1251 (2012)
institution DOAJ
collection DOAJ
language EN
topic Ophthalmology
RE1-994
spellingShingle Ophthalmology
RE1-994
Yokogawa H
Kobayashi A
Yamazaki N
Ishibashi Y
Oikawa Y
Tokoro M
Sugiyama K
Bowman’s layer encystment in cases of persistent Acanthamoeba keratitis
description Hideaki Yokogawa,1 Akira Kobayashi,1 Natsuko Yamazaki,1 Yasuhisa Ishibashi,2 Yosaburo Oikawa,3 Masaharu Tokoro,4 Kazuhisa Sugiyama11Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, 2Department of Ophthalmology, East Washinomiya Hospital, Kuki, 3Department of Medical Zoology, Kanazawa Medical University, Kahoku, 4Department of Parasitology, Kanazawa University Graduate School of Medical Science, Kanazawa, JapanBackground: The purpose of this study was to report Acanthamoeba encystment in Bowman’s layer in Japanese cases of persistent Acanthamoeba keratitis (AK).Methods: Laser confocal microscopic images of the cornea were obtained in vivo from 18 consecutive eyes from 17 confirmed AK patients. Retrospectively, 14 cases treated over 4 months were categorized as a nonpersistent group and three cases that required prolonged therapy for more than 6 months were categorized as a persistent group. Clinical outcomes based on final best-corrected visual acuity were retrospectively analyzed, and selected confocal images were evaluated qualitatively for abnormal findings.Results: The final best-corrected visual acuity was significantly lower (P < 0.01) for patients in the persistent group compared with that in the nonpersistent group. At the initial visit, in vivo confocal microscopy demonstrated Acanthamoeba cysts exclusively in the epithelial layer in both the nonpersistent group (80%) and the persistent group (100%). At a subsequent follow-up visit, numerous Acanthamoeba cysts were observed in the epithelial cell layer and in Bowman’s layer in all patients with persistent AK, but Acanthamoeba cysts were undetectable in all cases with nonpersistent AK tested.Conclusion: Invasion of cysts into Bowman’s layer was characteristically observed in patients with persistence of AK. This finding suggests that invasion of Acanthamoeba cysts into Bowman’s layer may be a useful predictor for a persistent clinical course.Keywords: Acanthamoeba keratitis, Bowman’s layer, encystment
format article
author Yokogawa H
Kobayashi A
Yamazaki N
Ishibashi Y
Oikawa Y
Tokoro M
Sugiyama K
author_facet Yokogawa H
Kobayashi A
Yamazaki N
Ishibashi Y
Oikawa Y
Tokoro M
Sugiyama K
author_sort Yokogawa H
title Bowman’s layer encystment in cases of persistent Acanthamoeba keratitis
title_short Bowman’s layer encystment in cases of persistent Acanthamoeba keratitis
title_full Bowman’s layer encystment in cases of persistent Acanthamoeba keratitis
title_fullStr Bowman’s layer encystment in cases of persistent Acanthamoeba keratitis
title_full_unstemmed Bowman’s layer encystment in cases of persistent Acanthamoeba keratitis
title_sort bowman’s layer encystment in cases of persistent acanthamoeba keratitis
publisher Dove Medical Press
publishDate 2012
url https://doaj.org/article/a8f74f5bf3a54f6788d466ac30488867
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