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In vivo confocal microscopy in fungal keratitis
  1. Emmanuelle Brasnu (ebrasnu{at}yahoo.fr),
  2. Tristan Bourcier (tristan.bourcier{at}chru-strasbourg.fr),
  3. Benedicte Dupas (dupas{at}quinze-vingts.fr),
  4. Sandrine Degorge (s.degorge{at}quinze-vingts.fr),
  5. Thibault Rodallec (t.rodallec{at}quinze-vingts.fr),
  6. Laurent Laroche (laurent-laroche{at}quinze-vingts.fr),
  7. Vincent Borderie (borderie{at}quinze-vingts.fr),
  8. Christophe Baudouin (baudouin{at}quinze-vingts.fr)
  1. Quinze-Vingts National Center of Ophthalmology, France
  2. Strasbourg Universitary Hospital, France
  3. Quinze-Vingts National Center of Ophthalmology, France
  4. Quinze-Vingts National Center of Ophthalmology, France
  5. Quinze-Vingts National Center of Ophthalmology, France
  6. Quinze-Vingts National Center of Ophthalmology, France
  7. Quinze-Vingts National Center of Ophthalmology, France
  8. Quinze-Vingts National Center of Ophthalmology, France

    Abstract

    Background/aims: Fungal keratitis is a major blinding eye disease found throughout the world, particularly in developing countries. Given the recent increase in Fusarium keratitis infections in contact lens wearers due to contact lens solutions, the Food and Drug Administration recently issued a warning, making it a public health concern in developed countries. Our purpose was to show the advantages of in vivo confocal microscopy imaging using the Heidelberg Retina Tomograph II-Rostock Cornea Module in the early diagnosis of fungal keratitis.

    Methods: Heidelberg Retina Tomograph II-Rostock Cornea Module confocal microscopy was performed on five patients presenting with Fungal keratitis and on three donor corneas contaminated with Fusarium solani, Aspergillus fumigatus, and Candida albicans.

    Results: Direct microscopic evaluation of corneal smears and culture revealed the presence of Fusarium solani in four cases and Candida albicans in one case. Heidelberg Retina Tomograph II-Rostock Cornea Module examination of the infected patients and contaminated donor corneas revealed numerous high-contrast elements resembling Fusarium, Aspergillus hyphae or Candida pseudo-filaments in the anterior stroma.

    Conclusion: Heidelberg Retina Tomograph II- Rostock Cornea Module in vivo confocal microscopy is a new, noninvasive and rapid technique for early diagnosis of fungal keratitis, showing high-resolution images resembling fungal structures at the early phase of the disease.

    • confocal microscopy
    • fungi
    • infection
    • keratitis

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