Случай успешного лечения двустороннего акантамебного кератита

G. I. Drozhzhina; A. V. Zborovskaya; V. L. Ostahevskiy; T. B. Gaydamaka; E. V. Vansovich; A. N. Kurilyuk

doi:10.31288/oftalmolzh20143119126

Authors

G. I. Drozhzhina SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"; Odesa (Ukraine)
A. V. Zborovskaya SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"; Odesa (Ukraine)
V. L. Ostahevskiy SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"; Odesa (Ukraine)
T. B. Gaydamaka SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"; Odesa (Ukraine)
E. V. Vansovich SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"; Odesa (Ukraine)
A. N. Kurilyuk SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"; Odesa (Ukraine)

DOI:

https://doi.org/10.31288/oftalmolzh20143119126

Keywords:

akanamebny keratitis, photodynamic therapy, methylene blue, dimeksid

Abstract

Introduction. Acanthamoeba keratitis is related to a severe pathology of the eye that results from infection of the human body by free-living amoeba in soil. This disease is characterized by loss of the corneal epithelium, stromal thinning, and development of radial keratoneuritis, appearance of the annular infiltration and formation of a central or paracentral corneal abscess.

Purpose. To describe a case of successful treatment of bilateral acanthamoeba keratitis where standard therapy was first supplemented with photodynamic therapy (PDT) using methylene blue and dimexid.

Material and Methods. There were used test of visual acuity, ophthalmoscopy, microbiological analysis.»

Results. Complex treatment of bilateral acanthamoeba keratitis, which includes different antiseptics, antifungal, amebicidal drugs, the use of pathogenetic and symptomatic therapy, and the use of PDT with methylene blue and dimexid allowed to stop inflammation and restore vision.

Conclusions. In the diagnosis of acanthamoeba keratitis the important role belongs to the anamnesis, biomicroscopy of the cornea with the identification of pseudodendritical figures or recurrent epithelial damage, which are the earliest clinical signs of the disease.Combined treatment of this disease in combination with PDT first used in the ophthalmic practice showed significant therapeutic effect.

References

1.Al-Astal Muhhamed Salih. Photodynamic therapy for corneal neovascularization using methylene blue and 578 nm wavelength laser: Author's thesis for Candidate of Med. Science: 14.00.08. Ophthalmology. Almaty.2006. 24 p.

2.Danfflchev VF. Modern ophthalmology. SPb; 2000.

3.Douglas Cullom, Benjamin Chang. Wills Eye Hospital. Diagnosis and treatment of eye diseases. Medytsyna svitu: Lviv; 1999. 69 p.

4.Maichuk YuF. Parasitic diseases of the eye. Moskva; 1988. 287 p.

5.Medvedev IB, Belikova Yel, Syamichev MP. Photodynam¬ic therapy in ophthalmology. M.; 2006. 129 p.

6.Okolov IN, Chaika NA, Egorova OV, Kaogaltseva NM et

al. Acanthamoeba and acanthamoeba keratitis. Manual for physicians. Saint Petersburg; 2005.

7.Stranadko YeF. Photodynamic therapy of malignant tumors and non-neoplastic diseases: 2 All-Russian symposium, 1997: proceedings. Moscow; 1997. 20- 3.

8.Wilhelm Happe. Ophthalmology. M.: MEDpress-inform; 2004. 99 p.

9.Aksozek A et al. Resistance of Acanthamoebacastellaniicysts to physical, chemical, and radiological conditions. J Parasitol. 2002;88 (3):621- 3. https://doi.org/10.1645/0022-3395(2002)088[0621:ROACCT]2.0.CO;2

10.Bacon AS, Frazer DG, Dart I et al. A review of 72 conservative cases of Acanthamoeba Keratitis, 1984- 1992. Eye. 1993;7:719-25.https://doi.org/10.1038/eye.1993.168

11.Buettner G, Oberly L. The apparent production of superoxide and hydroxyl radicals by hematoporphyrin and light as seen by spin-trapping. Fed. Biol. Sci. Letts. 1980;121:161-4.https://doi.org/10.1016/0014-5793(80)81288-9

12.DOG 2013. «First Results of the German Acanthamoeba Keratitis Registry». Szentmary N, Daas L., Epping T., et al.

13.Dougherty T. Photosensitization of malignant tumors / T. Dougherty // Semin. Surg. Oncol. - 1986. - Vol. 2. - P. 24- 37.https://doi.org/10.1002/ssu.2980020104

14.Ermis S. S. Treatment of Staphyiococcus Epidermidis Endophtalminis with Intravitreal Monoflocsacin in a Rab¬bit Model / S. S. Ermis, Z. Cetinkaya, H. Kiyici [et al.] // Tohoku J. Exp. Med. - 2005. - Vol. 205, № 3. - P. 223-229.https://doi.org/10.1620/tjem.205.223

15.Larkin D. F. et al. Treatment of Acanthamoeba keratitis with polyhexamethylenebiguanide // Ophthalmology. - 1992. - Vol. 99(2). - P.185-191.https://doi.org/10.1016/S0161-6420(92)31994-3

16.Malik Z. Antimicrobal and antiviral activity of porphyrin photosensitation / Z. Malik, H. Ladan, Y Nitzan [et al.] // Proc. of SPIE. - 1994. - Vol. 2078. - P. 305- 312.https://doi.org/10.1117/12.168668

17.Mathers W. D. et al. Outbreak of keratitis presumed to be caused by Acanthamoeba // Am J Ophthalmol. - 1996. - Vol.121(2). - P.129-142.https://doi.org/10.1016/S0002-9394(14)70577-X

18.Microbiologic factors and visual outcome in the Endo-phthalmitis Vitrectomy Study / Endophthalmitis Vitrec-tomy Study Group // Am. J. Ophthalmol. - 1996. - Vol.122. - P. 830-846.https://doi.org/10.1016/S0002-9394(14)70380-0

19.Patrice T. Photodynamic Therapy / Patrice T. - Cambridge : UK, 2003. - 287 p.https://doi.org/10.1039/9781847551658

20.Soukos N. S. Targeted Antimicrobial Photochemotherapy / N. S. Soukos, L. A. Ximenez-Fyvie, M. R. Hamblin // Antimicrob. Agents Chemother. - 1998. - Vol.42. - № 10. - P.2595- 2601.https://doi.org/10.1128/AAC.42.10.2595

21.Wainwright M. Photodynamic antimicrobial chemothera¬py (PACT) / M. Wainwright // J. Antimicrob. Chemother. - 1998. - Vol. 42. - P. 13-28.https://doi.org/10.1093/jac/42.1.13

22.Weishaupt K. Identification of singlet oxygen as the cytotoxic agent in photoinactivation of murine tumor / K. Weishaupt, C. Gomer, T. Dougherty // Cancer Res. - 1976. - Vol. 36. - P. 2326-2329.