PURPOSE: To determine the effectiveness of laser confocal microscopy in detecting filamentous fungi in the cornea of patients with fungal keratitis (FK) and in evaluating the effectiveness of the treatment. METHODS: The corneas of 6 patients clinically diagnosed with FK were examined with the Heidelberg Retina Tomograph II-Rostock Cornea Module (HRT II-RCM). Three of these patients were also monitored periodically with the HRT II-RCM after antifungal treatment. RESULTS: The HRT II-RCM examination showed interlocking and branching, white, septated, hyphae-like lines in the cornea of all patients. All 6 patients had positive corneal smears and/or laboratory cultures. Three patients were monitored with HRT II-RCM after antifungal treatment. One patient, whose initial smear was negative, was diagnosed by HRT II-RCM before the positive culture results. In another case, the epithelial regeneration was impaired even 3 weeks after the initial treatment and HRT II-RCM revealed a mass of hyphae in the corneal ulcerated lesion. These findings indicated the necessity of surgical debridement. After the surgical debridement, the corneal epithelial defect was healed. HRT II-RCM was able to detect the morphological changes of hyphae after antifungal treatment and helped in the treatment modifications during the clinical course in all 3 patients. CONCLUSIONS: These results indicate that HRT II-RCM can be used to diagnose FK and to monitor the effect of therapy on FK.
PURPOSE: To determine the effectiveness of laser confocal microscopy in detecting filamentous fungi in the cornea of patients with fungal keratitis (FK) and in evaluating the effectiveness of the treatment. METHODS: The corneas of 6 patients clinically diagnosed with FK were examined with the Heidelberg Retina Tomograph II-Rostock Cornea Module (HRT II-RCM). Three of these patients were also monitored periodically with the HRT II-RCM after antifungal treatment. RESULTS: The HRT II-RCM examination showed interlocking and branching, white, septated, hyphae-like lines in the cornea of all patients. All 6 patients had positive corneal smears and/or laboratory cultures. Three patients were monitored with HRT II-RCM after antifungal treatment. One patient, whose initial smear was negative, was diagnosed by HRT II-RCM before the positive culture results. In another case, the epithelial regeneration was impaired even 3 weeks after the initial treatment and HRT II-RCM revealed a mass of hyphae in the corneal ulcerated lesion. These findings indicated the necessity of surgical debridement. After the surgical debridement, the corneal epithelial defect was healed. HRT II-RCM was able to detect the morphological changes of hyphae after antifungal treatment and helped in the treatment modifications during the clinical course in all 3 patients. CONCLUSIONS: These results indicate that HRT II-RCM can be used to diagnose FK and to monitor the effect of therapy on FK.
Authors: Seyed Ali Tabatabaei; Mohammad Soleimani; Seyed Mehdi Tabatabaei; Amir Houshang Beheshtnejad; Niloufar Valipour; Shahram Mahmoudi Journal: Int Ophthalmol Date: 2019-11-07 Impact factor: 2.031
Authors: Brunella Posteraro; Romano Mattei; Fausto Trivella; Andrea Maffei; Antonio Torre; Elena De Carolis; Patrizia Posteraro; Giovanni Fadda; Maurizio Sanguinetti Journal: J Clin Microbiol Date: 2011-03-30 Impact factor: 5.948
Authors: Victoria Squissato; Yeni H Yucel; Susan E Richardson; Alaa Alkhotani; David T Wong; Navdeep Nijhawan; Clara C Chan Journal: Med Mycol Case Rep Date: 2015-06-05