Factors Influencing the Diagnostic Accuracy of Laser-Scanning In Vivo Confocal Microscopy for Acanthamoeba Keratitis

Kheirkhah, Ahmad; Satitpitakul, Vannarut; Syed, Zeba A.; Müller, Rodrigo; Goyal, Sunali; Tu, Elmer Y.; Dana, Reza

doi:10.1097/ico.0000000000001507

Cited by 23 publications

(23 citation statements)

References 35 publications

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“…IVCM allows the direct observation of fungal hyphae, spores, and acanthamoeba cysts in living corneas. 37 , 38 Previous clinical studies have shown that IVCM has good sensitivity and specificity in the diagnosis of fungal and acanthamoeba infection keratitis. IVCM may be missed or misdiagnosed in many cases, including corneal edema, excess necrotic tissue, or fungal hyphae in the deep stroma or on the endothelium surface.…”

Section: Discussionmentioning

confidence: 99%

Clinical Observation of Corneal Endothelial Plaques With Fungal and Bacterial Keratitis by Anterior Segment Optical Coherence Tomography and In Vivo Confocal Microscopy

Jin

Shi

et al. 2021

Cornea

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Section: Discussionmentioning

confidence: 99%

Clinical Observation of Corneal Endothelial Plaques With Fungal and Bacterial Keratitis by Anterior Segment Optical Coherence Tomography and In Vivo Confocal Microscopy

Jin

Shi

et al. 2021

Cornea

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“…In-vivo confocal microscopy is more sensitive than cultures and PCR for fungal and Acanthamoeba infections, but results are highly dependent on user experience level [39][40][41]. Anterior segment optical coherence tomography is another potentially useful modality in distinguishing fungal from bacterial and viral infection or in performing corneal endothelial biopsies [42][43][44].…”

Section: Diagnosticsmentioning

confidence: 99%

Therapy for contact lens-related ulcers

Jeang

Tuli

2022

Current Opinion in Ophthalmology

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Purpose of reviewThe current review covers the current literature and practice patterns of antimicrobial therapy for contact lens-related microbial keratitis (CLMK). Although the majority of corneal ulcers are bacterial, fungus and acanthamoeba are substantial contributors in CLMK and are harder to treat due to the lack of commercially available topical medications and low efficacy of available topical therapy.Recent findingsTopical antimicrobials remain the mainstay of therapy for corneal ulcers. Fluoroquinolones may be used as monotherapy for small, peripheral bacterial ulcers. Antibiotic resistance is a persistent problem. Fungal ulcers are less responsive to topical medications and adjunct oral or intrastromal antifungal medications may be helpful. Acanthamoeba keratitis continues to remain a therapeutic challenge but newer antifungal and antiparasitic agents may be helpful adjuncts. Other novel and innovative therapies are being studied currently and show promise.SummaryContact lens-associated microbial keratitis is a significant health issue that can cause vision loss. Treatment remains a challenge but many promising diagnostics and procedures are in the pipeline and offer hope.

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“…The effects of contact lenses on the eyes were evaluated with CSLM. Contact lens biocompatibility, its effects on cornea, limbal stem cells or conjunctiva, early diagnosis of devastating infections such as acanthamoeba keratitis are investigated by CSLM [35][36][37][38].…”

Section: Contact Lensmentioning

confidence: 99%

“…Its incidence is on the rise because of the increasing usage of contact lenses. The diagnose of acanthamoeba keratitis is essential as its devastating nature, and CSLM can be used as an adjunct modality to the clinical data for diagnosing acanthamoeba keratitis [38].…”

Section: Contact Lensmentioning

confidence: 99%

Confocal Scanning Laser Microscopy in Medicine

Kızıltoprak¹,

Ozkoyuncu²,

Tekin³

et al. 2021

Biomedical Signal and Image Processing

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Confocal Scanning Laser Microscopy (CSLM) offers high resolution morphological details and generates en-face images with excellent depth discrimination for visualizing different structures of the living human body non-invasively. There have been significant advances in technology since the CSLM was first defined. It has been used commonly, especially in ophthalmological area, in order to diagnose and give direction for the treatment of corneal pathologies. Ocular surface, corneal subbasal nerve plexus, filtering blebs of glaucoma surgery were also investigated widely by CSLM. With the improvements in CSLM technology over time, it is widely used in other fields than ophthalmology. The combined use of CSLM with the slit lamp biomicroscopy and optical coherence tomography will also lead to significant advances in the diagnosis and treatment of more diseases in the future.

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Factors Influencing the Diagnostic Accuracy of Laser-Scanning In Vivo Confocal Microscopy for Acanthamoeba Keratitis

Abstract: IVCM has a moderate sensitivity and a high specificity for diagnosis of AK. Although clinical parameters do not affect this diagnostic accuracy, a higher sensitivity is seen when images are interpreted by experienced observers.

Cited by 23 publications

References 35 publications

Clinical Observation of Corneal Endothelial Plaques With Fungal and Bacterial Keratitis by Anterior Segment Optical Coherence Tomography and In Vivo Confocal Microscopy

Clinical Observation of Corneal Endothelial Plaques With Fungal and Bacterial Keratitis by Anterior Segment Optical Coherence Tomography and In Vivo Confocal Microscopy

Therapy for contact lens-related ulcers

Confocal Scanning Laser Microscopy in Medicine

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