PMC3460707_01
Photograph of a 32-year-old Japanese woman who exhibited radial keratoneuritis at the eleven and one o'clock positions in her right eye.
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The right cornea exhibited radial keratoneuritis at both the eleven and one o'clock positions, and there were several centrally located scattered subepithelial lesions that were approximately 3 mm in diameter (Figure 1).
Direct examination of the specimens using the Parker ink-potassium hydroxide method revealed blue staining of Acanthamoeba material.
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Acanthamoeba-type material (Figure 2). Also, bacterial culture was performed using a corneal biopsy specimen, but the result was negative and confocal microscopy was not performed.
As the inflammation progressed, radial keratoneuritis was further observed at the eight, nine, ten, eleven, one, and three o'clock locations.
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However, neither the drug therapy nor the surgical intervention helped the patient, as both the conjunctival injection and pain increased, and there was an increase and deepening of the radial keratoneuritis (Figure 3).
Ultimately, the continued progression of the inflammation led to ulceration in the center of the cornea.. Note: At this point, the radial keratoneuritis had almost completely disappeared.
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Even with the additional treatment, there was a further widening of the corneal lesion (Figure 4).
Even though the therapeutic intervention finally cured the inflammation, corneal opacity remained at the original site of the infection.
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Although a dramatic improvement was noted in the patient, a mild central corneal opacity still remained at the site of original infection at the end of the treatment period (Figure 5).