The use of in vivo confocal microscopy in fungal keratitis - Progress and challenges

Fungal keratitis (FK) is a serious and sight-threatening corneal infection with global reach. The need for prompt diagnosis is paramount, as a delay in initiation of treatment could lead to irreversible vision loss. Current "gold standard" diagnostic methods, namely corneal smear and culture, have limitations due to diagnostic insensitivity and their time-consuming nature. PCR is a newer, complementary method used in the diagnosis of fungal keratitis, whose results are also sample-dependent. In vivo confocal microscopy (IVCM) is a promising complementary diagnostic method of increasing importance as it allows non-invasive real-time direct visualization of potential fungal pathogens and manifesting infection directly in the patients cornea. In numerous articles and case reports, FK diagnosis by IVCM has been evaluated, and different features, approaches, sensitivity/specificity, and limitations have been noted. Here, we provide an up-to-date, comprehensive review of the current literature and present the authors combined recommendations for fungal identification in IVCM images, while also looking to the future of FK assessment by IVCM using artificial intelligence methods.

Jackson, Catherine J.Ifocus Eye Clin, Norway; Univ Oslo, Norway (författare)
Utheim, Tor P.Sorlandet Hosp Arendal, Norway; Oslo Univ Hosp, Norway; Univ Agder, Norway (författare)
Villani, EdoardoUniv Milan, Italy; San Giuseppe Hosp, Italy (författare)
Hamrah, PedramTufts Univ, MA 02111 USA (författare)
Kheirkhah, AhmadUT Hlth San Antonio, TX USA (författare)
Nielsen, EsbenAarhus Univ Hosp, Denmark (författare)
Hau, ScottMoorfields Eye Hosp NHS Fdn Trust, England; UCL Inst Ophthalmol, England (författare)
Lagali, NeilLinköpings universitet,Avdelningen för sinnesorgan och kommunikation,Medicinska fakulteten,Region Östergötland, Ögonkliniken US,Sorlandet Hosp Arendal, Norway(Swepub:liu)neina50 (författare)
Sorlandet Hosp Arendal, NorwayIfocus Eye Clin, Norway; Univ Oslo, Norway (creator_code:org_t)

Av författaren/redakt...: Bakken, Ingvild ...; Jackson, Catheri ...; Utheim, Tor P.; Villani, Edoardo; Hamrah, Pedram; Kheirkhah, Ahmad; visa fler...; Nielsen, Esben; Hau, Scott; Lagali, Neil; visa färre...

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