Utility of real-time polymerase chain reaction in diagnosing and treating acanthamoeba keratitis

Cornea. 2011 Nov;30(11):1233-7. doi: 10.1097/ICO.0b013e3182032196.

Abstract

Purpose: Using real-time polymerase chain reaction (PCR), we detected Acanthamoeba and monitored the changes in Acanthamoeba DNA copy number over the treatment course in patients suspected of Acanthamoeba keratitis (AK).

Methods: Subjects were 6 patients (average age, 26.2 years) suspected of AK at the Kinki University Outpatient Clinic. For detection of Acanthamoeba, patients' corneal scrapings were collected for smear analysis, culture, and real-time PCR. After the diagnosis of AK was confirmed, treatment was initiated based on the quantitative result of the real-time PCR.

Results: Both the smear and culture were positive for Acanthamoeba in 4 cases and negative in 2 cases (agreement in 3 cases and disagreement in 2 cases). By real-time PCR, all 6 cases were positive for Acanthamoeba with an average DNA copy number of 4.8 ± 9.1 × 10 copies per sample. We further monitored the variation in the Acanthamoeba DNA copy number over the treatment course and successfully treated all the patients. DNA copy number provided a parallel with other clinical features of AK.

Conclusions: Real-time PCR can be a useful method for a rapid and precise diagnosis of AK. Moreover, utility of the Acanthamoeba DNA copy number obtained by real-time PCR can help ophthalmologists in making the best treatment decision.

Publication types

  • Case Reports

MeSH terms

  • Acanthamoeba / genetics
  • Acanthamoeba / isolation & purification*
  • Acanthamoeba Keratitis / diagnosis*
  • Acanthamoeba Keratitis / drug therapy*
  • Acanthamoeba Keratitis / parasitology
  • Adult
  • Antiprotozoal Agents / administration & dosage
  • Antiprotozoal Agents / therapeutic use
  • Chlorhexidine / administration & dosage
  • Chlorhexidine / therapeutic use
  • Contact Lenses, Hydrophilic / parasitology
  • Cornea / parasitology*
  • DNA Copy Number Variations
  • DNA, Protozoan / genetics
  • Female
  • Humans
  • Male
  • Miconazole / administration & dosage
  • Miconazole / therapeutic use
  • Ophthalmic Solutions
  • Real-Time Polymerase Chain Reaction*
  • Young Adult

Substances

  • Antiprotozoal Agents
  • DNA, Protozoan
  • Ophthalmic Solutions
  • Miconazole
  • Chlorhexidine