| Autor: |
Chidambaram, Jaya Devi, Prajna, Namperumalsamy Venkatesh, Larke, Natasha, Macleod, David, Srikanthi, Palepu, Lanjewar, Shruti, Shah, Manisha, Lalitha, Prajna, Elakkiya, Shanmugam, Burton, Matthew J |
| Zdroj: |
British Journal of Ophthalmology; 2017, Vol. 101 Issue: 8 p1119-1123, 5p |
| Abstrakt: |
BackgroundClinical outcomes in fungal keratitis vary between Fusariumand Aspergillusspp, therefore distinguishing between species using morphological features such as filament branching angles, sporulation along filaments (adventitious sporulation) or dichotomous branching may be useful. In this study, we assessed these three features within Heidelberg Retina Tomograph 3 in vivo confocal microscopy (IVCM) images from culture-positive Fusariumand Aspergillusspp keratitis participants.MethodsProspective observational cohort study in Aravind Eye Hospital (February 2011–February 2012). Eligibility criteria: age ≥18 years, stromal infiltrate ≥3 mm diameter, Fusariumor Aspergillusspp culture-positive. Exclusion criteria: previous/current herpetic keratitis, visual acuity <6/60 in fellow eye, >80% corneal thinning. IVCM was performed and images analysed for branch angle, presence/absence of adventitious sporulation or dichotomous branching by a grader masked to the microbiological diagnosis.Results98 participants were included (106 eligible, 8 excluded as no measurable branch angles); 68 were positive for Fusariumspp, 30 for Aspergillusspp. Mean branch angle for Fusariumspp was 59.7° (95% CI 57.7° to 61.8°), and for Aspergillusspp was 63.3° (95% CI 60.8° to 65.8°), p=0.07. No adventitious sporulation was detected in Fusariumspp ulcers. Dichotomous branching was detected in 11 ulcers (7 Aspergillusspp, 4 Fusariumspp).ConclusionsThere was very little difference in the branching angle of Fusariumand Aspergillusspp. Adventitious sporulation was not detected and dichotomous branching was infrequently seen. Although IVCM remains a valuable tool to detect fungal filaments in fungal keratitis, it cannot be used to distinguish Fusariumfrom Aspergillusspp and culture remains essential to determine fungal species. |
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