Confocal microscopy in the diagnosis of acanthamoeba keratitis

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PURPOSE

To evaluate the capabilities of corneal confocal microscopy (CCM) in the diagnosis of acanthamoeba keratitis.

MATERIAL AND METHODS

We examined 33 patients (35 eyes) with suspected acanthamoeba keratitis using light and laser confocal microscopy of the cornea (ConfoScan and HRT devices, respectively).

RESULTS

CCM was technically feasible in 23 of 35 cases (65.7%). Acanthamoeba cysts were detected in 16 cases (69.6%); trophozoites were visualized in 17.4% of cases; signs of keratoneuritis were detected in 12 eyes (52.2%); in 7 cases (30.4%), hyporeflective honeycomb-like cavities were observed in the stroma; deep stromal striae were observed in 9 cases (39.1%); activated keratocytes were detected in 11 patients (47.8%), and Langerhans cells were detected in 19 cases (82.6%).

CONCLUSIONS

The main diagnostic value of confocal microscopy is the detection of direct markers of AK — cysts and trophozoites of Acanthamoeba. Both light and laser CCM techniques are suitable for the diagnosis of AK, but the resolution of laser confocal microscopy is higher. The non-invasive nature of this method and the possibility of multiple subsequent examinations make it possible to verify the diagnosis of acanthamoeba keratitis and monitor the treatment.

Keywords:

corneal confocal microscopy

HRT

ConfoScan

acanthamoeba keratitis

cysts

trophozoites

keratoneuritis

activated keratocytes

Langerhans cells

Authors:

Kasparova E.A.

Krasnov Research Institute of Eye Diseases

ORCID: 0000-0001-8594-2395

Marchenko N.R.

Research Institute of Eye Diseases

ORCID: 0000-0001-6945-237X

Surnina Z.V.

Krasnov Research Institute of Eye Diseases

ORCID: 0000-0001-5692-1800

Mitichkina T.S.

Research Institute of Eye Diseases

Received:

30.12.2020

Accepted:

09.02.2021

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