The Application Of In Vivo Confocal Microscopy In The Diagnosis And Treatment Of Fungal Keratitis

Objectives:To evaluated the role of In Vivo Confocal Microscopy(IVCM) in the diagnosis and treatment of fungal keratitis.Methods:22eyes of22patients with FK at QILU hospital were studied,which were found out affected by fungus first time.All the patients routinely accepted the slit lamp microscopy,confocal microscopy and corneal scraping microscopic examination.Then the results were analysed to compare the advantages and disadvantages of modern method and the traditional one.The depth of fungus infiltrating into cornea was measured,combined with the effect of treatment,to explore the relationship between the depth of fungus and clinical prognosis.IVCM was given before and after the treatment two week and one month for observation of the existence of the hypha.Results:22patients were clinical diagnosed of fungal keratitis based on history,clinical signs and treatment response, among which the IVCM of20patients shows fungal filaments(90.9%) and13patients’cornea scraping examination were positive(59.1%).Among them,10cases(group1) were cured by medicine alone,the depth of fungal infiltration which was measured by IVCM was between8um to125um.And that of12patients(group2) who accepted the surgery,after the failure of medicine treatment,was between13um to213um.There is no statistically significant difference.Along with the progress of ulcer healing progress,we found out,through IVCM,that the density and boundary of fungus was decreasing and the the inflammation of the cornea was reduced.Conclusions:IVCM is more sensitive than cornea scraping examination;The depth of fungal invasion and the effect of drug treatment is independent,We should not evaluate the patients’ prognosis just according to the invasion depth;As a rapid and noninvasive examination,IVCM means a lot in the diagnose,observation and treatment of fungal keratitis.