PURPOSE: To clarify the characteristic appearances of early-stage Acanthamoeba keratitis (AK) and to investigate the effects of topical steroids on those appearances. SUBJECT AND METHODS: This study involved 25 eyes of 24 patients diagnosed as early-stage AK at Kyoto Prefectural University of Medicine between October 2002 and June 2008. All patients were contact lens wearers, and 23 patients (96%) were referred from other hospitals. Clinical findings in the medical records of all patients were analyzed retrospectively. RESULTS: Radial keratoneuritis was observed in 20 of 25 eyes (80%), and pseudodendritic lesions were observed in 15 eyes (60%). Only 1 eye (4%) showed neither of these two findings. Of the 10 eyes treated with topical steroids until the first presentation at our hospital, 6 eyes manifested radial keratoneuritis and/or pseudodendritic lesions after the discontinuation of that treatment. The visual prognosis was good in both groups, with or without topical steroid treatment. CONCLUSIONS: We found that radial keratoneuritis and pseudodendritic lesions are characteristic appearances of early-stage AK, and that topical steroid treatment might mask these characteristic findings.
PURPOSE: To clarify the characteristic appearances of early-stage Acanthamoeba keratitis (AK) and to investigate the effects of topical steroids on those appearances. SUBJECT AND METHODS: This study involved 25 eyes of 24 patients diagnosed as early-stage AK at Kyoto Prefectural University of Medicine between October 2002 and June 2008. All patients were contact lens wearers, and 23 patients (96%) were referred from other hospitals. Clinical findings in the medical records of all patients were analyzed retrospectively. RESULTS: Radial keratoneuritis was observed in 20 of 25 eyes (80%), and pseudodendritic lesions were observed in 15 eyes (60%). Only 1 eye (4%) showed neither of these two findings. Of the 10 eyes treated with topical steroids until the first presentation at our hospital, 6 eyes manifested radial keratoneuritis and/or pseudodendritic lesions after the discontinuation of that treatment. The visual prognosis was good in both groups, with or without topical steroid treatment. CONCLUSIONS: We found that radial keratoneuritis and pseudodendritic lesions are characteristic appearances of early-stage AK, and that topical steroid treatment might mask these characteristic findings.