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Impression cytology in eyes with clinical and confocal scan features of acanthamoeba keratitis.

AbstractPURPOSE:
To report impression cytology findings in specimens obtained from eyes with clinical and confocal microscopic features of Acanthamoeba keratitis (AK).
METHODS:
In this interventional case series, impression cytology was obtained from corneas of patients with clinical and confocal microscopic features indicative of AK. Specimens were stained with Periodic acid-Schiff/Papanicolaou (PAS/PAP) and examined for the presence of PAS-reactive Acanthamoeba cysts and/or hyperchromatic pear-shaped trophozoites. All specimens were then decolorized and re-stained with calcofluor white (CFW) for the presence of chemofluorescent cysts.
RESULTS:
Fifty-six eyes of 50 patients with mean age of 25.5±9.3 (range, 17 to 78) years were evaluated. Forty-one (82%) cases were female and 51 (91.1%) eyes had history of contact lens wear. PAS-reactive Acanthamoeba cysts and/or hyperchromatic pear-shaped trophozoites were identified in 53 eyes (94.6%), 2 of which demonstrated only trophozoite- like structures. CFW staining was able to reveal the presence of chemofluorescent cysts in all 51 specimens (91.1%) in which cysts had been demonstrated with PAS/PAP staining. Trophozoites were not detected with CFW due to background staining of the cellulose acetate strip used for impression cytology.
CONCLUSION:
Corneal impression cytology, stained with PAS/PAP or with CFW, successfully detects Acanthamoeba and can be employed for early noninvasive diagnosis of AK.
AuthorsMozhgan Rezaei Kanavi, Bagher Hosseini, Fatemeh Javadi, Nasser Rakhshani, Mohammad-Ali Javadi
JournalJournal of ophthalmic & vision research (J Ophthalmic Vis Res) Vol. 8 Issue 3 Pg. 207-12 (Jul 2013) ISSN: 2008-2010 [Print] United Arab Emirates
PMID24349663 (Publication Type: Journal Article)

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