Ledbetter Eric C, Irby Nita L, Kim Sung G
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
Vet Ophthalmol. 2011 Jan;14(1):1-9. doi: 10.1111/j.1463-5224.2010.00822.x.
To describe in vivo corneal confocal microscopy of horses with fungal keratitis and correlate findings with clinical, histopathological, and microbiological evaluations of clinical cases and an ex vivo experimental equine fungal keratitis model.
A total of 12 horses with naturally-acquired fungal keratitis and ex vivo equine corneas experimentally infected with clinical fungal isolates.
Horses with naturally-acquired fungal keratitis were examined with a modified Heidelberg Retina Tomograph II and Rostock Cornea Module. Confocal microscopy images of clinical isolates of Aspergillus fumigatus, Fusarium solani, and Candida albicans were obtained by examination of in vitro cultures and experimentally infected ex vivo equine corneas.
Non-specific in vivo corneal confocal microscopic findings in horses with fungal keratitis included leukocyte infiltrates, activated keratocytes, anterior stromal dendritic cell infiltrates, and vascularization. Linear, branching, hyper-reflective structures that were 2-6 μm in width and 200 to >400 μm in length were detected in all horses with filamentous fungal keratitis. Round to oval hyper-reflective structures that were 2-8 μm in diameter were detected in a horse with yeast fungal keratitis. The in vivo confocal microscopic appearance of the organisms was consistent with fungal morphologies observed during examination of in vitro cultures and infected ex vivo equine corneas.
In vivo corneal confocal microscopy is a rapid and non-invasive method of diagnosing fungal keratitis in the horse. This imaging technique is useful for both ulcerative and non-ulcerative fungal keratitis, and is particularly advantageous for confirming the presence of fungi in deep corneal stromal lesions.
描述患有真菌性角膜炎马匹的活体角膜共焦显微镜检查情况，并将检查结果与临床病例的临床、组织病理学和微生物学评估以及离体实验性马真菌性角膜炎模型进行关联。
总共12匹患有自然获得性真菌性角膜炎的马匹以及经临床真菌分离株实验性感染的离体马角膜。
使用改良的海德堡视网膜断层扫描仪II和罗斯托克角膜模块对患有自然获得性真菌性角膜炎的马匹进行检查。通过检查体外培养物和实验性感染的离体马角膜，获得烟曲霉、茄病镰刀菌和白色念珠菌临床分离株的共焦显微镜图像。
患有真菌性角膜炎的马匹活体角膜共焦显微镜检查的非特异性结果包括白细胞浸润、活化的角膜细胞、前基质树突状细胞浸润和血管化。在所有患有丝状真菌性角膜炎的马匹中均检测到宽度为2 - 6μm、长度为200至>400μm的线性、分支状、高反射结构。在一匹患有酵母真菌性角膜炎的马匹中检测到直径为2 - 8μm的圆形至椭圆形高反射结构。生物体的活体共焦显微镜外观与体外培养物和感染的离体马角膜检查期间观察到的真菌形态一致。
活体角膜共焦显微镜检查是诊断马真菌性角膜炎的一种快速且非侵入性的方法。这种成像技术对溃疡性和非溃疡性真菌性角膜炎均有用，并且对于确认深层角膜基质病变中真菌的存在特别有利。
