Role of confocal microscopy in deep fungal keratitis.
OBJECTIVE
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.


METHODS
Retrospective, noncomparative case series.


METHODS
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.


RESULTS
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.


CONCLUSIONS
In vivo confocal microscopy can be a useful diagnostic tool in patients presenting with deep stromal lesions.
Das
Sujata
S
Cornea and Anterior Segment Service, LV Prasad Eye Institute, Bhubaneswar, Orissa, India. sujatadas@lvpei.org
Samant
Monica
M
Garg
Prashant
P
Vaddavalli
Pravin Krishna
PK
Vemuganti
Geeta K
GK
D000328:Adult; D003315:Cornea / Q000382:microbiology; D003319:Corneal Stroma / Q000473:pathology*; D015821:Eye Infections, Fungal; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007634:Keratitis / Q000382:microbiology* / Q000473:pathology*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult