A case of medication-resistant acanthamoeba keratitis treated by corneal crosslinking in Turkey

Abstract

Acanthamoeba keratitis (AK) is a rare, vision-threatening, necrotizing corneal disease caused by small, free-living amoebae belonging to the genus Acanthamoeba. They are typically uninucleated, active, motile trophozoites but form a doublewalled cyst and become dormant when exposed to harsh environmental conditions [1]. The first AK case was reported in 1974 and case reports increased in 1984, particularly among contact lens wearers [2]. AK typically presents with severe pain and associated radial neuritis, inflammation, redness, and photophobia. AK is the most clinically challenging form of ophthalmologic keratitis. In the past, AK symptoms often led ophthalmologists to incorrectly diagnose herpetic keratitis. Mathers et al. showed that, in some series of herpetic keratitis, AK was also present as an opportunistic infection [3]. Combination drug therapy is highly effective only with early diagnosis. With late diagnosis, medical therapy may be insufficient to stop disease progression, and penetrating keratoplasty (PKP) may be required