Antiinfektiöse medikamentöse Therapie in der Augenheilkunde - Teil 4: Akanthamöben

Zusammenfassung

Gezielte Anamneseerhebung und Spaltlampenmikroskopie erlauben in aller Regel die Diagnose einer Akanthamöbenkeratitis bereits im Frühstadium. In Zweifelsfällen können konfokale Mikroskopie, mikrobiologische und histopathologische Untersuchungen zur Sicherung der Diagnose beitragen. Mit konservativen Maßnahmen (lokale Kombinationstherapie mit Aminoglykosiden, Polyhexamethylenbiguanid 0,02 %, Propamidinisoethionat 0,1 %) kann im Frühstadium eine vollständige Visusrehabilitierung erreicht werden. Im Spätstadium ist jedoch eine perforierende Keratoplastik oft unumgänglich.

Abstract

An early diagnosis of an acanthamoeba keratitis can usually be made on the basis of the patient’s history and slit-lamp examination. Further helpful diagnostic steps are confocal microscopy, microbiological, and histopathological examination. In the early stages topical application of antimicrobials (combined application of aminoglycosides, polyhexamethylene biguanide 0.02 %, propamidine isoethionate 0.1 %) is effective. In the late stages a penetrating keratoplasty is often necessary.

Schlüsselwörter

Akanthamöben - Keratitis - Hornhautinfiltrat - Hornhautulkus - Keratoplastik

Key words

Acanthamoeba - keratitis - corneal infiltrate - corneal ulcer - keratoplasty

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