Das Sujata, Samant Monica, Garg Prashant, Vaddavalli Pravin Krishna, Vemuganti Geeta K
Cornea and Anterior Segment Service, LV Prasad Eye Institute, Bhubaneswar, Orissa, India.
Cornea. 2009 Jan;28(1):11-3. doi: 10.1097/ICO.0b013e318181cff7.
The purpose of this study was to assess the role of in vivo confocal microscopy in cases of fungal keratitis presenting with a deep stromal infiltrate.
Retrospective, noncomparative case series.
We reviewed the medical, microbiologic, and histopathologic data of 6 patients, whose clinical presentation was characterized by deep stromal or multifocal endothelial lesions. These patients were subjected to in vivo confocal microscopy on the day of presentation. All the patients underwent therapeutic penetrating keratoplasty. The excised corneal buttons were bisected and subjected to microbiologic and histopathologic examinations.
Microbiologic and/or histopathologic examination proved that the keratitis in all the 6 patients was caused by filamentous fungi. Five corneal buttons were positive for the fungus on histopathologic examination. Four specimens grew out fungus on microbiologic examination. In 5 (83%) cases, confocal microscopy revealed double-walled, septate, linear branching structures resembling fungal filaments.
In vivo confocal microscopy can be a useful diagnostic tool in patients presenting with deep stromal lesions.
本研究旨在评估活体共聚焦显微镜在表现为深层基质浸润的真菌性角膜炎病例中的作用。
回顾性、非对照病例系列。
我们回顾了6例患者的医学、微生物学和组织病理学数据，这些患者的临床表现以深层基质或多灶性内皮病变为特征。这些患者在就诊当天接受了活体共聚焦显微镜检查。所有患者均接受了治疗性穿透性角膜移植术。将切除的角膜片切成两半，进行微生物学和组织病理学检查。
微生物学和/或组织病理学检查证明，所有6例患者的角膜炎均由丝状真菌引起。5个角膜片在组织病理学检查中真菌呈阳性。4个标本在微生物学检查中培养出真菌。在5例（83%）病例中，共聚焦显微镜显示出类似真菌丝的双壁分隔线性分支结构。
活体共聚焦显微镜对于表现为深层基质病变的患者可能是一种有用的诊断工具。
