title: In vivo confocal microscopy in fungal keratitis.
abstract: BACKGROUND
  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 owing to contact lens solutions, a warning was recently issued by the Food and Drug Administration, making it a public health concern in developed countries.
  
  
  OBJECTIVE
  To show the advantages of in vivo confocal microscopy imaging using the Heidelberg Retina Tomograph II-Rostock Cornea Module (HRTII-RCM) in the early diagnosis of fungal keratitis.
  
  
  METHODS
  HRTII-RCM 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 F solani in four cases and C albicans in one case. HRTII-RCM examination of the infected patients and contaminated donor corneas revealed numerous high-contrast elements resembling Fusarium, Aspergillus hyphae or Candida pseudofilaments in the anterior stroma.
  
  
  CONCLUSIONS
  HRTII-RCM in vivo confocal microscopy is a new, non-invasive and rapid technique for the early diagnosis of fungal keratitis, showing high-resolution images resembling fungal structures in the early phase of the disease.
authors.affiliation: Department of Ophthalmology III, Quinze-Vingts National Center of Ophthalmology, Paris, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Brasnu
authors.forename: Tristan
authors.initials: T
authors.lastname: Bourcier
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Dupas
authors.forename: Sandrine
authors.initials: S
authors.lastname: Degorge
authors.forename: Thibault
authors.initials: T
authors.lastname: Rodallec
authors.forename: Laurent
authors.initials: L
authors.lastname: Laroche
authors.forename: Vincent
authors.initials: V
authors.lastname: Borderie
authors.forename: Christophe
authors.initials: C
authors.lastname: Baudouin
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015821:Eye Infections, Fungal / Q000473:pathology*; D005260:Female; D006801:Humans; D007634:Keratitis / Q000382:microbiology*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged