title: Cytoarchitecture of epithelial inflammatory infiltration indicates the aetiology of infectious keratitis.
abstract: OBJECTIVE
  To analyse cytological features of corneal epithelium in infectious keratitis.
  
  
  METHODS
  One hundred and eighteen patients (53 males and 65 females) diagnosed with acute stage of infectious keratitis (45 viral, 40 bacterial, 23 fungal, 10 Acanthamoeba keratitis) were included in study. We performed retrospective analysis of bright and blue-light slit-lamp photographs and in vivo corneal confocal microscopy scans of the corneal epithelium from five corneal regions (superior, inferior, temporal, nasal and central). Density, morphology of inflammatory cells and their relation to epithelial structures, as well as density of nerve fibres, were evaluated in relation to the keratitis aetiology.
  
  
  RESULTS
  We characterized five morphological types of inflammatory cells forming infiltration. Cell and nerve fibre densities showed significant differences between groups, and the most intense inflammatory infiltration was associated with fungal then bacterial, viral and Acanthamoeba keratitis. Additionally, differences in aetiology-specific ratio of round/non-round inflammatory cells were observed.
  
  
  CONCLUSIONS
  Confocal microscopy analysis in infectious keratitis of various aetiologies revealed quantitative and qualitative differences in inflammatory cell infiltration expressed in different ratio of round/non-round inflammatory cells. In vivo microscopic analysis of both the corneal epithelial layer cytopathology and the cytology of inflammatory infiltration provides a fast and specific differentiation of keratitis aetiology that may increase the accuracy in the selection of the initial treatment.
authors.affiliation: Department of Ophthalmology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.|Chair and Department of Physiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
authors.forename: Adrian
authors.initials: A
authors.lastname: Smedowski
authors.affiliation: Department of Ophthalmology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.|Department of Biophysics and Molecular Physics, Institute of Physics, University of Silesia, Katowice, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Tarnawska
authors.affiliation: Department of Ophthalmology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
authors.forename: Michal
authors.initials: M
authors.lastname: Orski
authors.affiliation: Department of Ophthalmology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Wroblewska-Czajka
authors.affiliation: Department of Ophthalmology, University of Eastern Finland, Kuopio, Finland.|Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Kai
authors.initials: K
authors.lastname: Kaarniranta
authors.affiliation: Department of Experimental Medical-Surgical Sciences, Ocular Surface Diseases Unit, University of Messina, Messina, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Aragona
authors.affiliation: Department of Ophthalmology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
authors.forename: Edward
authors.initials: E
authors.lastname: Wylegala
mesh_terms: D000328:Adult; D019573:Epithelium, Corneal / Q000473:pathology*; D015817:Eye Infections / Q000209:etiology / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007634:Keratitis / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies
keywords: corneal epithelium; infectious keratitis; inflammatory cells; in vivo corneal confocal microscopy