Corneal cross-linking for Acanthamoeba keratitis in an orthokeratology patient after swimming in contaminated water
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/1822/31321 |
Resumo: | Purpose: To report a case of Acanthamoeba keratitis diagnosed using confocal microscopy in a patient corrected by orthokeratology and treated with corneal crosslinking (CXL) after failure to respond to medical treatment. Methods: After diagnosis, the patient was treated with several medications until CXL was applied during one 30-min session using ultraviolet A radiation and application of riboflavin. The clinical signs of the disease observed using slit-lamp biomicroscopy and confocal microscopy were evaluated and the visual acuity was measured during the course of the infection and treatment over a period of 30 months including 12 months of medical treatment, 9 months after cross-linking and amniotic membrane transplant and 9 months after penetrating keratoplasty and cataract extraction. Results: In this case, confocal microscopy facilitated early diagnosis of an Acanthamoeba infection even if other signs and symptoms might be confounding. CXL was more effective than aggressive medication against the microorganism. After CXL, the symptoms and the corneal appearance improved significantly but the ulcer did not heal completely. After amniotic membrane transplantation, the patient underwent penetrating keratoplasty (PK) with no rejection, and the visual function substantially improved over 9 months of follow-up. Conclusions: Swimming in contaminated water might represent a risk for orthokeratology patients. CXL was effective for treating Acanthamoeba keratitis in an orthokeratology patient to eliminate active and cystic forms of the microorganism. Confocal microscopy was useful to confirm the diagnosis in the presence of confounding clinical signs observed during a conventional slit-lamp examination. Both CXL and confocal microscopy are essential to the outcome of PK |
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Corneal cross-linking for Acanthamoeba keratitis in an orthokeratology patient after swimming in contaminated waterAcanthamoeba keratitisCXLOrthokeratologyConfocal microscopyAmniotic membranePenetrating keratoplastyScience & TechnologyPurpose: To report a case of Acanthamoeba keratitis diagnosed using confocal microscopy in a patient corrected by orthokeratology and treated with corneal crosslinking (CXL) after failure to respond to medical treatment. Methods: After diagnosis, the patient was treated with several medications until CXL was applied during one 30-min session using ultraviolet A radiation and application of riboflavin. The clinical signs of the disease observed using slit-lamp biomicroscopy and confocal microscopy were evaluated and the visual acuity was measured during the course of the infection and treatment over a period of 30 months including 12 months of medical treatment, 9 months after cross-linking and amniotic membrane transplant and 9 months after penetrating keratoplasty and cataract extraction. Results: In this case, confocal microscopy facilitated early diagnosis of an Acanthamoeba infection even if other signs and symptoms might be confounding. CXL was more effective than aggressive medication against the microorganism. After CXL, the symptoms and the corneal appearance improved significantly but the ulcer did not heal completely. After amniotic membrane transplantation, the patient underwent penetrating keratoplasty (PK) with no rejection, and the visual function substantially improved over 9 months of follow-up. Conclusions: Swimming in contaminated water might represent a risk for orthokeratology patients. CXL was effective for treating Acanthamoeba keratitis in an orthokeratology patient to eliminate active and cystic forms of the microorganism. Confocal microscopy was useful to confirm the diagnosis in the presence of confounding clinical signs observed during a conventional slit-lamp examination. Both CXL and confocal microscopy are essential to the outcome of PKElsevierUniversidade do MinhoArance-Gil, ÁngelesGutiérrez, Ángel RamónVilla-Collar, CésarNieto-Bona, AmeliaFerreira, Daniela LopesGonzález-Méijome, José Manuel20142014-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/1822/31321eng1367-048410.1016/j.clae.2013.11.00824355444info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-21T12:39:01ZPortal AgregadorONG |
dc.title.none.fl_str_mv |
Corneal cross-linking for Acanthamoeba keratitis in an orthokeratology patient after swimming in contaminated water |
title |
Corneal cross-linking for Acanthamoeba keratitis in an orthokeratology patient after swimming in contaminated water |
spellingShingle |
Corneal cross-linking for Acanthamoeba keratitis in an orthokeratology patient after swimming in contaminated water Arance-Gil, Ángeles Acanthamoeba keratitis CXL Orthokeratology Confocal microscopy Amniotic membrane Penetrating keratoplasty Science & Technology |
title_short |
Corneal cross-linking for Acanthamoeba keratitis in an orthokeratology patient after swimming in contaminated water |
title_full |
Corneal cross-linking for Acanthamoeba keratitis in an orthokeratology patient after swimming in contaminated water |
title_fullStr |
Corneal cross-linking for Acanthamoeba keratitis in an orthokeratology patient after swimming in contaminated water |
title_full_unstemmed |
Corneal cross-linking for Acanthamoeba keratitis in an orthokeratology patient after swimming in contaminated water |
title_sort |
Corneal cross-linking for Acanthamoeba keratitis in an orthokeratology patient after swimming in contaminated water |
author |
Arance-Gil, Ángeles |
author_facet |
Arance-Gil, Ángeles Gutiérrez, Ángel Ramón Villa-Collar, César Nieto-Bona, Amelia Ferreira, Daniela Lopes González-Méijome, José Manuel |
author_role |
author |
author2 |
Gutiérrez, Ángel Ramón Villa-Collar, César Nieto-Bona, Amelia Ferreira, Daniela Lopes González-Méijome, José Manuel |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Universidade do Minho |
dc.contributor.author.fl_str_mv |
Arance-Gil, Ángeles Gutiérrez, Ángel Ramón Villa-Collar, César Nieto-Bona, Amelia Ferreira, Daniela Lopes González-Méijome, José Manuel |
dc.subject.por.fl_str_mv |
Acanthamoeba keratitis CXL Orthokeratology Confocal microscopy Amniotic membrane Penetrating keratoplasty Science & Technology |
topic |
Acanthamoeba keratitis CXL Orthokeratology Confocal microscopy Amniotic membrane Penetrating keratoplasty Science & Technology |
description |
Purpose: To report a case of Acanthamoeba keratitis diagnosed using confocal microscopy in a patient corrected by orthokeratology and treated with corneal crosslinking (CXL) after failure to respond to medical treatment. Methods: After diagnosis, the patient was treated with several medications until CXL was applied during one 30-min session using ultraviolet A radiation and application of riboflavin. The clinical signs of the disease observed using slit-lamp biomicroscopy and confocal microscopy were evaluated and the visual acuity was measured during the course of the infection and treatment over a period of 30 months including 12 months of medical treatment, 9 months after cross-linking and amniotic membrane transplant and 9 months after penetrating keratoplasty and cataract extraction. Results: In this case, confocal microscopy facilitated early diagnosis of an Acanthamoeba infection even if other signs and symptoms might be confounding. CXL was more effective than aggressive medication against the microorganism. After CXL, the symptoms and the corneal appearance improved significantly but the ulcer did not heal completely. After amniotic membrane transplantation, the patient underwent penetrating keratoplasty (PK) with no rejection, and the visual function substantially improved over 9 months of follow-up. Conclusions: Swimming in contaminated water might represent a risk for orthokeratology patients. CXL was effective for treating Acanthamoeba keratitis in an orthokeratology patient to eliminate active and cystic forms of the microorganism. Confocal microscopy was useful to confirm the diagnosis in the presence of confounding clinical signs observed during a conventional slit-lamp examination. Both CXL and confocal microscopy are essential to the outcome of PK |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014 2014-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1822/31321 |
url |
http://hdl.handle.net/1822/31321 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
1367-0484 10.1016/j.clae.2013.11.008 24355444 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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repository.mail.fl_str_mv |
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1777303808862322688 |