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مقاله
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Abstract
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Title:
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Importance of Confocal Scan in the Diagnosis and Treatment of Infectious Keratitis
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Author(s):
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Mozhgan Rezaei Kanavi,1, Marzieh Sadat Hashemi Manshadi,2, Seyed Bagher Hosseini, 2
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Presentation Type:
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Oral
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Subject:
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Cornea
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Others:
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Presenting Author:
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Name:
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Mansoor Shahriari
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Affiliation :(optional)
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1.Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2.Central Eye Bank of Iran, Tehran, Iran.
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E mail:
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mrezaie47@yahoo.com
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Phone:
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22525126
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Mobile:
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09121964663
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Purpose:
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This study was conducted to investigate the importance of confocal scan in addition to smear and culture in the diagnosis and treatment of patients with clinical diagnosis of infectious keratitis.
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Methods:
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Patients with clinical diagnosis of infectious keratitis underwent biomicroscopic examinations and corneal confocal scanning between November 2011 and March 2014. Pending the results of slitlamp biomicroscopy and confocal scan, corneal smear and culture were performed and medical treatment targeting the infectious etiology was performed. Final paraclinical results and the rate of response to medical therapy were statistically analyzed.
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Results:
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264 cases with mean age of 40.7 years were investigated; 162 (61.4%) were female. Major causes leading to keratitis were contact lens wearing (42.8%, n=113), ocular traumas (34.5%, n=91), and prior ocular surgery (17.0%, n=45). Biomicroscopic and confocal scan results were suggestive of bacterial keratitis (BK) in 91 (34.5%), acanthamoeba keratitis (AK) in 68 (25.8%), fungal keratitis (FK) in 48 (18.2%), non-specific keratitis (NSK) in 40 (15.1%), and infectious crystalline keratopathy (ICK) in 17 (6.4%). 41% of BK and 48% of FK cases had positive results for smear and/or culture. 7 AK cases had smear and culture; 2 of which yielded positive results for acanthamoeba. None of NSK and ICK cases had positive microbiologic results. Response to specific medical treatment was observed in 87.9% of BK, 88.2% of AK, 81.3% of FK, 67.5% of NSK and 76.5% of ICK cases. Patients that were non-responsive to medical treatment underwent tectonic graft.
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Conclusion:
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Implementation of confocal scan in addition to smear and culture increases the rate of correct diagnosis in cases with infectious keratitis, leading to proper management in such cases through disclosing the presence or absence of acanthamoeba or fungal elements in the examined cornea. Performing confocal scan, as a safe and non-invasive diagnostic tool, in addition to traditional smear and culture should be considered in all patients with infectious keratitis.
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Attachment:
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