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Confocal microscopy in fungal keratitis early diagnostics: first experience

Poster Details

First Author: M.Solomatin LATVIA

Co Author(s):    T. Petrova   A. Solomatin   S. Veldre              

Abstract Details

Purpose:

To analyze the clinical application of confocal microscopy in fungal keratitis diagnostics and to present the importance of confocal microscopy in the early diagnostics of corneal inflammatory diseases.

Setting:

The study was conducted at the opthalmology department of Riga East Clinical University Hospital from 19.02.2014 to 18.03.2015.

Methods:

Five young patients, all contact lens wearers, were presented in the ophthalmology department with complaints of decreased vision acuity and corneal syndrome. Wide corneal infiltrate and ulcer was visualized during the slit lamp examination. The microbiological material was collected from the corneal infiltrate and ex-juvantibus treatment with broad spectrum A/B therapy was started. Negative dynamics. Corneal confocal microscopy was performed on the next day. Signs of fungal infection was visualized. Local antifungal treatment was started. Mirobiological approve of corneal material fungal infection was reported on 5th day of treatment. Penetrating corneal transplantation was performed in three patients.

Results:

The study shows that the diagnosis of fungal infection was not diagnosed initially. Penetrating keratoplasty and correct treatment scheme helped to stop the progression of the disease.

Conclusions:

Initial misdiagnosis of fungal infection is common because early presentations are variable. Culture examination are necessary for diagnosis, but frequently they are time-consuming. In –Vivo confocal microscopy is noninvasive imaging technique that provide high resolution corneal images and can help to come to right diagnosis quicker. Contact lens wearers are under increased risk of fungal infection.

Financial Disclosure:

NONE

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