Ophthalmology in images
Microscopic features of an Acanthamoeba polyphaga keratitis
Múltiple presentación microscópica de una queratitis por Acanthamoeba polyphaga
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"apellidos" => "Barranco González" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357942200175X?idApp=UINPBA00004N" "url" => "/21735794/0000009800000002/v2_202302221953/S217357942200175X/v2_202302221953/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Ophthalmology in images</span>" "titulo" => "Microscopic features of an <span class="elsevierStyleItalic">Acanthamoeba polyphaga</span> keratitis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "121" "paginaFinal" => "122" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "G. García de Oteyza, A.M. García-Albisua, K.A. Vázquez-Romo" "autores" => array:3 [ 0 => array:4 [ "nombre" => "G." "apellidos" => "García de Oteyza" "email" => array:1 [ 0 => "gonzalo_gdeoteyza@hotmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "A.M." "apellidos" => "García-Albisua" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "K.A." "apellidos" => "Vázquez-Romo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Clínica Oftalmológica García de Oteyza, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Asociación Para Evitar la Ceguera en México, Departamento de Córnea y Cirugía Refractiva, Hospital Luis Sánchez Bulnes, Mexico City, Mexico" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Múltiple presentación microscópica de una queratitis por <span class="elsevierStyleItalic">Acanthamoeba polyphaga</span>" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1241 "Ancho" => 1874 "Tamanyo" => 343397 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0080" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Macro and microscopic presentation of the case.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Male, 22, diagnosed with Acanthamoeba keratitis when presenting with severe pain, red eye and annular infiltrate after a history of swimming in a spring water well while wearing contact lenses (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). Despite topical treatment, oral medication and intervention with a PACK (cross-linking), the depth and density of the Acanthamoeba cysts required therapeutic keratoplasty. Microbiological, anatomopathological and electron microscopy images can be seen below, showing Acanthamoeba polyphaga trophozoites (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B, asterisks) on non-nutrient agar, where the characteristic pulsating vacuole is visible. <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C shows Acanthamoeba cysts deep in the stroma (S), very close to Descemet's membrane (Dm) (PAS, original magnification ×40). <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D shows double-walled refringent cysts with 6 endocytic walls and paracentral nuclei (white flashes) (PAS, original magnification ×100). In <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>E, the walls of 2 cysts (black flashes) in the stroma are clearly visible (Grocott, original magnification ×100). Finally, a mature Acanthamoeba polyphaga cyst is shown in detail in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>F, wherein the double wall, the exocyst (Exo), the endocyst (Endo), the operculum (Op) and the nucleus (N) are differentiated by transmission electron microscopy.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0010" class="elsevierStylePara elsevierViewall">No conflicts of interest were declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 1 => array:2 [ "identificador" => "xack653050" "titulo" => "Acknowledgements" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1241 "Ancho" => 1874 "Tamanyo" => 343397 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0080" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Macro and microscopic presentation of the case.</p>" ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack653050" "titulo" => "Acknowledgements" "texto" => "<p id="par0015" class="elsevierStylePara elsevierViewall">The authors wish to thank the Department of Molecular Pathogenesis at the Center for Research and Advanced Studies in Mexico City for the acquisition of the microscopy images of this patient.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009800000002/v2_202302221953/S2173579423000142/v2_202302221953/en/main.assets" "Apartado" => array:4 [ "identificador" => "95363" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Ophthalmology in images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009800000002/v2_202302221953/S2173579423000142/v2_202302221953/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579423000142?idApp=UINPBA00004N" ]
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