ENHANCED DIAGNOSIS OF ACANTHAMOEBA KERATITIS

描述：阿米巴角膜炎被认为是一种相对罕见的 严重的角膜感染会导致视力下降。 它最常与使用隐形眼镜有关。 的 通过简单的上皮活检和组织学检查确诊 由眼科病理学家进行检查。 在过去的三年里， 检查了400例角膜炎患者，并确定了106例 角膜中的假定阿米巴，随后用 上皮活检 只有一个案例我们成功地培养了 有机体 PI的一般假设是阿米巴角膜炎 代表了一种未被诊断的人类角膜机会性感染 这会对健康造成严重危害。 它比普通的 以前认为。 这种疾病的诊断和管理将是 通过更精确、更快速的诊断工具， 共聚焦显微镜和聚合酶链反应（PCR）。 我们在此建议 研究目的：1）确定亚临床或无症状的患病率 共聚焦显微镜检查正常人群阿米巴感染 显微镜下，一系列正常患者和接受上皮细胞移植的患者 在近视矫正前摘除。 检查眼库眼睛与共聚焦 显微镜检查、组织学检查和PCR检查是否存在阿米巴。 2)确定 临床、亚临床或无症状角膜棘阿米巴的患病率 各种形式的角膜病患者的感染，包括假定的 细菌性角膜炎、糖尿病性上皮病、基底膜营养不良， 单纯疱疹性角膜炎和带状疱疹性角膜炎，并确认 组织学、培养和PCR诊断。 3)确定以下疾病的患病率 临床或亚临床棘阿米巴感染的患者， 易受急性感染，包括戴隐形眼镜的病人， 正常上皮或上皮疾病的证据，如点状 角膜炎或微囊肿。 有临床和共聚焦证据的患者 疾病将有一个上皮活检进一步诊断。 四、 通过开发聚合酶来表征我们已经鉴定的生物体 链反应（PCR）检测，提高我们的培养技术，从而 更准确地描述这些生物。

DESCRIPTION: Acanthamoeba keratitis has been considered a relatively rare and severe form of corneal infection which causes debilitating visual loss. It has most frequently been associated with the use of contact lenses. The diagnosis is confirmed with a simple epithelial biopsy and histologic examination by an ophthalmic pathologist. In the last three years, we have examined 400 patients with keratitis and have identified 106 patients with presumed Acanthamoeba in the cornea, each subsequently confirmed with an epithelial biopsy. In only one case have we been successful in culturing the organism. It is the PI general hypothesis that Acanthamoeba keratitis represents an underdiagnosed opportunistic infection of the human cornea which can present a significant health hazard. It is much more common than previously thought. The diagnosis and management of this disease will be greatly improved with more precise and rapid diagnostic tools including confocal microscopy and polymerase chain reaction (PCR). We propose in this research to: 1) Determine the prevalence of subclinical or asymptomatic Acanthamoeba infection in the normal population by examining, with confocal microscopy, a series of normal patients and patients undergoing epithelial removal prior to PRK for myopia. Examine Eye Bank eyes with confocal microscopy, histology, and PCR for the presence of amoeba. 2) Determine the prevalence of clinical, subclinical, or asymptomatic corneal acanthamoeba infections in patients with various forms of keratopathy including presumed bacterial keratitis, diabetic epitheliopathy, basement membrane dystrophy, herpes simplex keratitis and herpes zoster keratitis and confirm the diagnosis with histology, culture and PCR. 3) Determine the prevalence of clinical or subclinical acanthamoeba infection in patients particularly prone to acute infection including patients wearing contact lenses who have normal epithelium or evidence of epithelial disease such as punctate keratitis or microcysts. Patients with clinical and confocal evidence of disease will have an epithelial biopsy for further diagnosis. 4) Characterize the organisms we have identified by developing a polymerase chain reaction (PCR) assay, enhance our culture techniques, and thereby characterize more precisely these organisms.