Klin Monbl Augenheilkd 2011; 228(3): R29-R43
DOI: 10.1055/s-0030-1270800
KliMo-Refresher
Rubrikherausgeber: G. Duncker, Halle, C. Meltendorf, Halle
© Georg Thieme Verlag KG Stuttgart · New York

Akanthamöben-Keratitis

C. Meltendorf1 , G. Duncker1
  • 1Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität, Halle
Further Information

Publication History

Publication Date:
03 March 2011 (online)

Einleitung

Die durch Akanthamöben hervorgerufene Keratitis stellt aufgrund der Variabilität ihres klinischen Erscheinungsbilds, der damit einhergehenden späten Diagnosestellung, des teilweise fehlenden Ansprechens der zur Verfügung stehenden Medikamente und des protrahierten klinischen Verlaufs eine besondere Herausforderung für den Augenarzt dar.

Die ersten Fälle, bei denen Akanthamöben als Ursache einer Keratitis beim Menschen nachgewiesen wurden, stammen aus den frühen 1970er-Jahren [1], [2]. Zu einer dramatischen Zunahme der Inzidenz an Akanthamöben-Keratitiden kam es Mitte der 1980er-Jahre durch die zunehmende Anwendung von Kontaktlinsen zur Refraktionskorrektur [3], [4], [5]. Von den kontaktlinsenassoziierten mikrobiellen Keratitiden sind heutzutage etwa 5 % durch Akanthamöben verursacht [6], [7].

Literatur

  • 1 Naginton J, Watson P G, Playfair T J et al. Amoebic infection of the eye.  Lancet. 1974;  2 1537-1540
  • 2 Jones D B, Visvesvara G S, Robinson N M. Acanthamoeba polyphaga keratitis and Acenthamoeba uveitis associated with fatal meningoencephalitis.  Trans Ophthalmol Soc UK. 1975;  95 221-232
  • 3 Ku J Y, Chan F M, Beckingsale P. Acanthamoeba keratitis cluster: an increase in Acanthamoeba keratitis in Australia.  Clin Experiment Ophthalmol. 2009;  37 181-190
  • 4 Moore M B, McCulley J P, Newton C et al. Acanthamoeba keratitis. A growing problem in soft and hard contact lens wearers.  Ophthalmology. 1987;  94 1654-1661
  • 5 Schaumberg D A, Snow K K, Dana M R. The epidemic of Acanthamoeba keratitis: where do we stand?.  Cornea. 1998;  17 3-10
  • 6 Butler T K, Males J J, Robinson L P et al. Six-year review of Acanthamoeba keratitis in New South Wales, Australia: 1997–2002.  Clin Experiment Ophthalmol. 2005;  33 41-46
  • 7 Acharya N R, Lietman T M, Margolis T P. Parasites on the rise: a new epidemic of Acanthamoeba keratitis.  Am J Ophthalmol. 2007;  144 292-293
  • 8 Pschyrembel. Klinisches Wörterbuch.. 259. Aufl. Berlin: de Gruyter; 2002
  • 9 Marciano-Cabral F, Cabral G. Acanthamoeba spp. as agents of disease in humans.  Clin Microbiol Rev. 2003;  16 273-307
  • 10 Pussard M, Pons R. Morphologies de la paroi kystique et taxonomie du genre Acanthamoeba (Protozoa, Amoebida).  Protistologica. 1977;  13 557-610
  • 11 Stothard D R, Hay J, Schroeder-Diedrich J M et al. Fluorescent oligonucleotide probes for clinical and environmental detection of Acanthamoeba and the T4 18S rRNA gene sequence type.  J Clin Microbiol. 1999;  37 2687-2693
  • 12 Walochnik J, Haller-Schober E, Kolli H et al. Discrimination between clinically relevant and nonrelevant Acanthamoeba strains isolated from contact lens wearing keratitis patients in Austria.  J Clin Microbiol. 2000;  38 3932-3936
  • 13 Stothard D R, Schroeder-Diedrich J M, Awwad M H et al. The evolutionary history of the genus Acanthamoeba and the identification of eight new 18S rRNA gene sequence types.  J Eukaryot Microbiol. 1998;  45 45-54
  • 14 Weekers P H, Bodelier P L, Wijen J P et al. Effects of grazing by the free-living soil amoebae Acanthamoeba castellanii, Acanthamoeba polyphaga, and Hartmannella vermiformis on various bacteria.  Appl Environ Microbiol. 1993;  59 2317-2319
  • 15 Chagla A H, Griffiths A J. Growth and encystation of Acanthamoeba castellanii.  J Gen Microbiol. 1974;  85 139-145
  • 16 De Jonckheere J, van de Voorde H. Differences in destruction of cysts of pathogenic and nonpathogenic Naegleria and Acanthamoeba by chlorine.  Appl Environ Microbiol. 1976;  31 294-297
  • 17 Khunkitti W, Lloyd D, Furr J R et al. Acanthamoeba castellanii: growth, encystment, excystment and biocide susceptibility.  J Infect. 1998;  36 43-48
  • 18 Brown T J, Cursons R T. Pathogenic free-living amebae (PFLA) from frozen swimming areas in Oslo, Norway.  Scand J Infect Dis. 1977;  9 237-240
  • 19 Aksozek A, McClellan K, Howard K et al. Resistance of Acanthamoeba castellanii cysts to physical, chemical, and radiological conditions.  J Parasitol. 2002;  88 621-623
  • 20 Mazur T, Hadas E, Iwanicka I. The duration of the cyst stage and the viability and virulence of Acanthamoeba isolates.  Trop Med Parasitol. 1995;  46 106-108
  • 21 Michel R, Burghardt H, Bergmann H. Acanthamoeba, naturally intracellularly infected with Pseudomonas aeruginosa, after their isolation from a microbiologically contaminated drinking water system in a hospital.  Zentralbl Hyg Umweltmed. 1995;  196 532-544
  • 22 Barker J, Scaife H, Brown M R. Intraphagocytic growth induces an antibiotic-resistant phenotype of Legionella pneumophila.  Antimicrob Agents Chemother. 1995;  39 2684-2688
  • 23 Seal D V. Acanthamoeba keratitis update-incidence, molecular epidemiology and new drugs for treatment.  Eye (Lond). 2003;  17 893-905
  • 24 Dart J K, Saw V P, Kilvington S. Acanthamoeba keratitis: diagnosis and treatment update 2009.  Am J Ophthalmol. 2009;  148 487-499
  • 25 Tu E Y, Joslin C E. Recent outbreaks of atypical contact lens-related keratitis: what have we learned?.  Am J Ophthalmol. 2010;  150 602-608
  • 26 Foulks G N. Acanthamoeba keratitis and contact lens wear: static or increasing problem?.  Eye Contact Lens. 2007;  33 412-414 discussion 414-415
  • 27 Bacon A S, Frazer D G, Dart J K et al. A review of 72 consecutive cases of Acanthamoeba keratitis, 1984–1992.  Eye (Lond). 1993;  7 (Pt 6) 719-725
  • 28 Carvalho F R, Foronda A S, Mannis M J et al. Twenty years of Acanthamoeba keratitis.  Cornea. 2009;  28 516-519
  • 29 McAllum P, Bahar I, Kaiserman I et al. Temporal and seasonal trends in Acanthamoeba keratitis.  Cornea. 2009;  28 7-10
  • 30 Radford C F, Lehmann O J, Dart J K. National Acanthamoeba Keratitis Study Group . Acanthamoeba keratitis: multicentre survey in England 1992–6.  Br J Ophthalmol. 1998;  82 1387-1392
  • 31 Chew H F, Yildiz E H, Hammersmith K M et al. Clinical outcomes and prognostic factors associated with Acanthamoeba keratitis.  Cornea. 2010;  epub ahead of print
  • 32 Centers for Disease Control and Prevention (CDC) . Acanthamoeba keratitis multiple states, 2005–2007.  MMWR Morb Mortal Wkly Rep. 2007;  56 532-534
  • 33 Johnston S P, Sriram R, Qvarnstrom Y et al. Resistance of Acanthamoeba cysts to disinfection in multiple contact lens solutions.  J Clin Microbiol. 2009;  47 2040-2045
  • 34 Hammersmith K M. Diagnosis and management of Acanthamoeba keratitis.  Curr Opin Ophthalmol. 2006;  17 327-331
  • 35 Watt K, Swarbrick H A. Microbial keratitis in overnight orthokeratology: review of the first 50 cases.  Eye Contact Lens. 2005;  31 201-208
  • 36 Stehr-Green J K, Bailey T M, Visvesvara G S. The epidemiology of Acanthamoeba keratitis in the United States.  Am J Ophthalmol. 1989;  107 331-336
  • 37 Radford C F, Minassian D C, Dart J K. Acanthamoeba keratitis in England and Wales: incidence, outcome, and risk factors.  Br J Ophthalmol. 2002;  86 536-542
  • 38 Sharma S, Garg P, Rao G N. Patient characteristics, diagnosis, and treatment of non-contact lens related Acanthamoeba keratitis.  Br J Ophthalmol. 2000;  84 1103-1108
  • 39 Camposampiero D, Caramello G, Indemini P et al. Two red eyes and one asymptomatic donor.  Lancet. 2009;  374 1792
  • 40 Panjwani N. Pathogenesis of Acanthamoeba keratitis.  Ocul Surf. 2010;  8 70-79
  • 41 Clarke D W, Niederkorn J Y. The pathophysiology of Acanthamoeba keratitis.  Trends Parasitol. 2006;  22 175-180
  • 42 van Klink F, Alizadeh H, He Y et al. The role of contact lenses, trauma, and Langerhans cells in a Chinese hamster model of Acanthamoeba keratitis.  Invest Ophthalmol Vis Sci. 1993;  34 1937-1944
  • 43 Hadas E, Mazur T. Proteolytic enzymes of pathogenic and non-pathogenic strains of Acanthamoeba spp.  Trop Med Parasitol. 1993;  44 197-200
  • 44 Clarke D W, Alizadeh H, Niederkorn J Y. Failure of Acanthamoeba castellanii to produce intraocular infections.  Invest Ophthalmol Vis Sci. 2005;  46 2472-2478
  • 45 Niederkorn J Y, Alizadeh H, Leher H F et al. The immunobiology of Acanthamoeba keratitis.  Springer Semin Immunopathol. 1999;  21 147-160
  • 46 Sun X, Zhang Y, Li R et al. Acanthamoeba keratitis: clinical characteristics and management.  Ophthalmology. 2006;  113 412-416
  • 47 Claerhout I, Goegebuer A, Van Den Broecke C et al. Delay in diagnosis and outcome of Acanthamoeba keratitis.  Graefes Arch Clin Exp Ophthalmol. 2004;  242 648-653
  • 48 Reinhard T, Behrens-Baumann W. Anti-infective drug therapy in ophthalmology – part 4: Acanthamoeba keratitis.  Klin Monbl Augenheilkd. 2006;  223 485-492
  • 49 Stemberger K, Dick B, Kramann C et al. Painless Acanthamoeba keratitis.  Ophthalmologe. 2007;  104 415-417
  • 50 Wilhelmus K R, Jones D B, Matoba A Y et al. Bilateral Acanthamoeba keratitis.  Am J Ophthalmol. 2008;  145 193-197
  • 51 Perry H D, Donnenfeld E D, Foulks G N et al. Decreased corneal sensation as an initial feature of Acanthamoeba keratitis.  Ophthalmology. 1995;  102 1565-1568
  • 52 Awwad S T, Petroll W M, McCulley J P et al. Updates in Acanthamoeba keratitis.  Eye Contact Lens. 2007;  33 1-8
  • 53 Patel D V, McGhee C N. Acanthamoeba keratitis: a comprehensive photographic reference of common and uncommon signs.  Clin Experiment Ophthalmol. 2009;  37 232-238
  • 54 Nakano E, Oliveira M, Portellinha W et al. Confocal microscopy in early diagnosis of Acanthamoeba keratitis.  J Refract Surg. 2004;  20 S737-740
  • 55 Illingworth C D, Cook S D, Karabatsas C H et al. Acanthamoeba keratitis: risk factors and outcome.  Br J Ophthalmol. 1995;  79 1078-1082
  • 56 Moore M B, McCulley J P, Kaufman H E et al. Radial keratoneuritis as a presenting sign in Acanthamoeba keratitis.  Ophthalmology. 1986;  93 1310-1315
  • 57 Niederkorn J Y, Alizadeh H, Leher H et al. The pathogenesis of Acanthamoeba keratitis.  Microbes Infect. 1999;  1 437-443
  • 58 Holbach L M, Hinzpeter E N, Naumann G O H. Kornea und Sklera.. Naumann G OH, Hrsg. Pathologie des Auges.. Heidelberg: Springer; 1986: 631-632
  • 59 Herz N L, Matoba A Y, Wilhelmus K R. Rapidly progressive cataract and iris atrophy during treatment of Acanthamoeba keratitis.  Ophthalmology. 2008;  115 866-869
  • 60 Kelley P S, Dossey A P, Patel D et al. Secondary glaucoma associated with advanced acanthamoeba keratitis.  Eye Contact Lens. 2006;  32 178-182
  • 61 Awwad S T, Heilman M, Hogan R N et al. Severe reactive ischemic posterior segment inflammation in acanthamoeba keratitis: a new potentially blinding syndrome.  Ophthalmology. 2007;  114 313-320
  • 62 Moshari A, McLean I W, Dodds M T et al. Chorioretinitis after keratitis caused by Acanthamoeba: case report and review of the literature.  Ophthalmology. 2001;  108 2232-2236
  • 63 Ebrahimi K B, Green W R, Grebe R et al. Acanthamoeba sclerokeratitis.  Graefes Arch Clin Exp Ophthalmol. 2009;  247 283-286
  • 64 Cavanagh H D, Petroll W M, Alizadeh H et al. Clinical and diagnostic use of in vivo confocal microscopy in patients with corneal disease.  Ophthalmology. 1993;  100 1444-1454
  • 65 Auran J D, Starr M B, Koester C J et al. In vivo scanning slit confocal microscopy of Acanthamoeba keratitis. A case report.  Cornea. 1994;  13 183-185
  • 66 Pfister D R, Cameron J D, Krachmer J H et al. Confocal microscopy findings of Acanthamoeba keratitis.  Am J Ophthalmol. 1996;  121 119-128
  • 67 Mathers W D, Nelson S E, Lane J L et al. Confirmation of confocal microscopy diagnosis of Acanthamoeba keratitis using polymerase chain reaction analysis.  Arch Ophthalmol. 2000;  118 178-183
  • 68 Parmar D N, Awwad S T, Petroll W M et al. Tandem scanning confocal corneal microscopy in the diagnosis of suspected acanthamoeba keratitis.  Ophthalmology. 2006;  113 538-547
  • 69 Efron N. Contact lens-induced changes in the anterior eye as observed in vivo with the confocal microscope.  Prog Retin Eye Res. 2007;  26 398-436
  • 70 Mathers W D. Acanthamoeba: a difficult pathogen to evaluate and treat.  Cornea. 2004;  23 325
  • 71 Tu E Y, Joslin C E, Sugar J et al. The relative value of confocal microscopy and superficial corneal scrapings in the diagnosis of Acanthamoeba keratitis.  Cornea. 2008;  27 764-772
  • 72 Gray T B, Cursons R T, Sherwan J F et al. Acanthamoeba, bacterial, and fungal contamination of contact lens storage cases.  Br J Ophthalmol. 1995;  79 601-605
  • 73 Larkin D F, Kilvington S, Easty D L. Contamination of contact lens storage cases by Acanthamoeba and bacteria.  Br J Ophthalmol. 1990;  74 133-135
  • 75 Aspöck H. Grundzüge der Diagnostik.. In: Hiepe T, Lucius R, Gottstein B Allgemeine Parasitologie mit den Grundzügen der Immunologie, Diagnostik und Bekämpfung.. Stuttgart: Parey in MVS Medizinverlage; 2006: 477
  • 76 Riviere D, Szczebara F M, Berjeaud J M et al. Development of a real-time PCR assay for quantification of Acanthamoeba trophozoites and cysts.  J Microbiol Methods. 2006;  64 78-83
  • 77 Mathers W D, Sutphin J E, Folberg R et al. Outbreak of keratitis presumed to be caused by Acanthamoeba.  Am J Ophthalmol. 1996;  121 129-142
  • 78 Wilhelmus K R, Osato M S, Font R L et al. Rapid diagnosis of Acanthamoeba keratitis using calcofluor white.  Arch Ophthalmol. 1986;  104 1309-1312
  • 79 Duguid I G, Dart J K, Morlet N et al. Outcome of acanthamoeba keratitis treated with polyhexamethyl biguanide and propamidine.  Ophthalmology. 1997;  104 1587-1592
  • 80 Lehmann O J, Green S M, Morlet N et al. Polymerase chain reaction analysis of corneal epithelial and tear samples in the diagnosis of Acanthamoeba keratitis.  Invest Ophthalmol Vis Sci. 1998;  39 1261-1265
  • 81 Qvarnstrom Y, Visvesvara G S, Sriram R et al. Multiplex real-time PCR assay for simultaneous detection of Acanthamoeba spp., Balamuthia mandrillaris, and Naegleria fowleri.  J Clin Microbiol. 2006;  44 3589-3595
  • 82 Thompson P P, Kowalski R P, Shanks R M et al. Validation of real-time PCR for laboratory diagnosis of Acanthamoeba keratitis.  J Clin Microbiol. 2008;  46 3232-3236
  • 83 Bacon A S, Dart J K, Ficker L A et al. Acanthamoeba keratitis. The value of early diagnosis.  Ophthalmology. 1993;  100 1238-1243
  • 84 Tu E Y, Joslin C E, Sugar J et al. Prognostic factors affecting visual outcome in Acanthamoeba keratitis.  Ophthalmology. 2008;  115 1998-2003
  • 85 Brooks jr. J G, Coster D J, Badenoch P R. Acanthamoeba keratitis. Resolution after epithelial debridement.  Cornea. 1994;  13 186-189
  • 86 Holland G N, Donzis P B. Rapid resolution of early Acanthamoeba keratitis after epithelial debridement.  Am J Ophthalmol. 1987;  104 87-89
  • 87 Ishibashi Y, Matsumoto Y, Kabata T et al. Oral itraconazole and topical miconazole with debridement for Acanthamoeba keratitis.  Am J Ophthalmol. 1990;  109 121-126
  • 88 Elder M J, Kilvington S, Dart J K. A clinicopathologic study of in vitro sensitivity testing and Acanthamoeba keratitis.  Invest Ophthalmol Vis Sci. 1994;  35 1059-1064
  • 89 Hay J, Kirkness C M, Seal D V et al. Drug resistance and Acanthamoeba keratitis: the quest for alternative antiprotozoal chemotherapy.  Eye (Lond). 1994;  8 (Pt 5) 555-563
  • 90 Larkin D F, Kilvington S, Dart J K. Treatment of Acanthamoeba keratitis with polyhexamethylene biguanide.  Ophthalmology. 1992;  99 185-191
  • 91 Kaehn K. Polihexanide: a safe and highly effective biocide.  Skin Pharmacol Physiol. 2010;  23 (Suppl.) 7-16
  • 92 Ficker L, Seal D, Warhurst D et al. Acanthamoeba keratitis – resistance to medical therapy.  Eye (Lond). 1990;  4 (Pt 6) 835-838
  • 93 D'Aversa G, Stern G A, Driebe jr. W T. Diagnosis and successful medical treatment of Acanthamoeba keratitis.  Arch Ophthalmol. 1995;  113 1120-1123
  • 94 McClellan K, Howard K, Niederkorn J Y et al. Effect of steroids on Acanthamoeba cysts and trophozoites.  Invest Ophthalmol Vis Sci. 2001;  42 2885-2893
  • 95 Berger S T, Mondino B J, Hoft R H et al. Successful medical management of Acanthamoeba keratitis.  Am J Ophthalmol. 1990;  110 395-403
  • 96 Amoils S P, Heney C. Acanthamoeba keratitis with live isolates treated with cryosurgery and fluconazole.  Am J Ophthalmol. 1999;  127 718-720
  • 97 Tu E Y, Joslin C E, Shoff M E. Successful treatment of chronic stromal acanthamoeba keratitis with oral voriconazole monotherapy.  Cornea. 2010;  29 1066-1068
  • 98 Bang S, Edell E, Eghrari A O et al. Treatment with voriconazole in 3 eyes with resistant Acanthamoeba keratitis.  Am J Ophthalmol. 2010;  149 66-69
  • 99 Berufsverband der Augenärzte Deutschlands .Leitlinie Nr. 13 Keratitis. 1998
  • 100 Lindquist T D. Treatment of Acanthamoeba keratitis.  Cornea. 1998;  17 11-16
  • 101 Murdoch D, Gray T B, Cursons R et al. Acanthamoeba keratitis in New Zealand, including two cases with in vivo resistance to polyhexamethylene biguanide.  Aust N Z J Ophthalmol. 1998;  26 231-236
  • 102 Binder P S. Cryotherapy for medically unresponsive Acanthamoeba keratitis.  Cornea. 1989;  8 106-114
  • 103 Reinhard T, Sundmacher R. Clinical aspects and therapy of Acanthamoeba keratitis.  Ophthalmologe. 2000;  97 446-459
  • 104 Kluppel M, Reinhard T, Sundmacher R et al. Therapy of advanced amoeba keratitis with keratoplasty a chaud and adjuvant cryotherapy.  Ophthalmologe. 1997;  94 99-103
  • 105 Matoba A Y, Pare P D, Le T D et al. The effects of freezing and antibiotics on the viability of Acanthamoeba cysts.  Arch Ophthalmol. 1989;  107 439-440
  • 106 Osato M S, Robinson N M, Wilhelmus K R et al. In vitro evaluation of antimicrobial compounds for cysticidal activity against Acanthamoeba.  Rev Infect Dis. 1991;  13 (Suppl. 5) S431-S435
  • 107 Meisler D M, Ludwig I H, Rutherford I et al. Susceptibility of Acanthamoeba to cryotherapeutic method.  Arch Ophthalmol. 1986;  104 130-131
  • 108 Kashiwabuchi R T, de Freitas D, Alvarenga L S et al. Corneal graft survival after therapeutic keratoplasty for Acanthamoeba keratitis.  Acta Ophthalmol. 2008;  86 666-669
  • 109 Sony P, Sharma N, Vajpayee RB et al. Therapeutic keratoplasty for infectious keratitis: a review of the literature.  CLAO J. 2002;  28 111-118
  • 110 Ficker L A, Kirkness C, Wright P. Prognosis for keratoplasty in Acanthamoeba keratitis.  Ophthalmology. 1993;  100 105-110
  • 111 Bourcier T, Patteau F, Borderie V et al. Amniotic membrane transplantation for the treatment severe acanthamoeba keratitis.  Can J Ophthalmol. 2004;  39 621-631
  • 112 Hargrave S L, McCulley J P, Husseini Z. Results of a trial of combined propamidine isethionate and neomycin therapy for Acanthamoeba keratitis. Brolene Study Group.  Ophthalmology. 1999;  106 952-957
  • 113 Kitzmann A S, Goins K M, Sutphin J E et al. Keratoplasty for treatment of Acanthamoeba keratitis.  Ophthalmology. 2009;  116 864-869
  • 114 Wermund T K, Wilhelm F, Susskind D et al. Recurrent Acanthamoeba keratitis in the corneal graft.  Klin Monbl Augenheilkd. 2009;  226 507-509
  • 115 Thebpatiphat N, Hammersmith K M, Rocha F N et al. Acanthamoeba keratitis: a parasite on the rise.  Cornea. 2007;  26 701-706

Dr. Christian Meltendorf, FEBO

Martin-Luther-Universität Halle-Wittenberg
Universitätsklinik und Poliklinik für Augenheilkunde

Ernst-Grube-Straße 40

06120 Halle (Saale)

Phone: 0345-5571562

Fax: 0345-5571848

Email: christian.meltendorf@medizin.uni-halle.de

    >