ENHANCED DIAGNOSIS OF ACANTHAMOEBA KERATITIS

描述：棘阿米巴角膜炎被认为是一种相对罕见的疾病 以及严重的角膜感染，导致视力丧失。 它最常与隐形眼镜的使用有关。 的 通过简单的上皮活检和组织学检查即可确诊 由眼科病理学家进行检查。 在过去的三年里，我们 检查了 400 名角膜炎患者，并确定了 106 名患者患有角膜炎。 推测角膜中存在棘阿米巴，随后均通过 上皮活检。 我们只成功培养了一个案例 有机体。 PI的一般假设是棘阿米巴角膜炎 代表未确诊的人类角膜机会性感染 这可能会造成严重的健康危害。 它比 之前以为。 该疾病的诊断和治疗将 通过更精确和快速的诊断工具，包括 共聚焦显微镜和聚合酶链反应（PCR）。 我们在此提出 研究目的： 1) 确定亚临床或无症状的患病率 通过共聚焦检查正常人群中的棘阿米巴感染 显微镜检查，一系列正常患者和接受上皮细胞治疗的患者 近视 PRK 前摘除。 用共焦检查眼库眼睛 显微镜检查、组织学检查和 PCR 检测阿米巴原虫的存在。 2）确定 临床、亚临床或无症状角膜棘阿米巴的患病率 患有各种形式的角膜病的患者的感染，包括推测的 细菌性角膜炎、糖尿病上皮病、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 通过组织学、培养和 PCR 进行诊断。 3) 确定患病率 临床或亚临床棘阿米巴感染患者，特别是 容易发生急性感染，包括戴隐形眼镜的患者 正常上皮或上皮疾病的证据，例如点状 角膜炎或微囊肿。 具有临床和共聚焦证据的患者 疾病将进行上皮活检以进一步诊断。 4） 通过开发聚合酶来表征我们已识别的生物体 链式反应 (PCR) 检测，增强我们的培养技术，从而 更准确地表征这些生物体。

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.