In vivo confocal microscopy appearance of Fusarium and Aspergillus species in fungal keratitis.
In vivo confocal microscopy appearance of Fusarium and Aspergillus species in fungal keratitis.
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DOI：
10.1136/bjophthalmol-2016-309656
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发表时间：
2017-08
期刊：
影响因子：
--
通讯作者：
Burton MJ
中科院分区：
文献类型：
--
作者：
Chidambaram JD;Prajna NV;Larke N;Macleod D;Srikanthi P;Lanjewar S;Shah M;Lalitha P;Elakkiya S;Burton MJ
真菌性角膜炎的临床结局在镰刀菌属和曲霉属之间存在差异，因此使用形态学特征（如丝状体分支角度、沿丝状体沿着孢子形成（不定孢子形成）或二歧分支）区分菌种可能是有用的。在这项研究中，我们评估了这三个功能在海德堡视网膜断层扫描仪3在体内共聚焦显微镜（IVCM）图像培养阳性镰刀菌和曲霉属角膜炎的参与者。在Aravind眼科医院进行的前瞻性观察性队列研究（2011年2月至2012年2月）。合格标准：年龄≥18岁，基质浸润直径≥3 mm，镰刀菌或曲霉菌培养阳性。 排除标准：既往/当前患有疱疹性角膜炎，对侧眼视力<6/60，>80%角膜变薄。进行IVCM，并由对微生物诊断设盲的分级员分析图像的分支角度、是否存在外源孢子形成或二歧分支。98名参与者被纳入（106名合格，8名因无法测量分支角度而被排除）; 68名镰刀菌属阳性，30名曲霉菌属阳性。镰刀菌属的平均分支角为59.7°（95% CI 57.7°至61.8°），曲霉菌属的平均分支角为63.3°（95% CI 60.8°至65.8°），p=0.07。在溃疡镰刀菌中没有检测到不定孢子形成。在11个溃疡中检测到二歧分支（曲霉菌属7个，镰刀菌属4个）。镰刀菌和曲霉的分枝角度差异很小。不定孢子形成没有检测到和二歧分支很少看到。虽然IVCM仍然是一个有价值的工具，检测真菌性角膜炎中的真菌丝，它不能用来区分镰刀菌属和曲霉属，文化仍然是必不可少的，以确定真菌物种。
Clinical outcomes in fungal keratitis vary between Fusarium and Aspergillus spp, 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 Fusarium and Aspergillus spp keratitis participants. Prospective observational cohort study in Aravind Eye Hospital (February 2011–February 2012). Eligibility criteria: age ≥18 years, stromal infiltrate ≥3 mm diameter, Fusarium or Aspergillus spp 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. 98 participants were included (106 eligible, 8 excluded as no measurable branch angles); 68 were positive for Fusarium spp, 30 for Aspergillus spp. Mean branch angle for Fusarium spp was 59.7° (95% CI 57.7° to 61.8°), and for Aspergillus spp was 63.3° (95% CI 60.8° to 65.8°), p=0.07. No adventitious sporulation was detected in Fusarium spp ulcers. Dichotomous branching was detected in 11 ulcers (7 Aspergillus spp, 4 Fusarium spp). There was very little difference in the branching angle of Fusarium and Aspergillus spp. 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 Fusarium from Aspergillus spp and culture remains essential to determine fungal species.
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影响因子：
14.2
作者：
Tortorano, A. M.;Richardson, M.;Lass-Floerl, C.
通讯作者：
Lass-Floerl, C.
影响因子：
3.5
作者：
Sangoi, Ankur R.;Rogers, William M.;Banaei, Niaz
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Banaei, Niaz
影响因子：
2.7
作者：
Schofield, Christina M.;Murray, Clinton K.;Hospenthal, Duane R.
通讯作者：
Hospenthal, Duane R.
影响因子：
4.1
作者：
Brasnu, Emmanuelle;Bourcier, Tristan;Baudouin, Christophe
通讯作者：
Baudouin, Christophe
影响因子：
4.2
作者：
Lalitha, Prajna;Sun, Catherine Q.;Prajna, N. Venkatesh;Karpagam, Rajarathinam;Geetha, Manoharan;O'Brien, Kieran S.;Cevallos, Vicky;McLeod, Stephen D.;Acharya, Nisha R.;Lietman, Thomas M.
通讯作者：
Lietman, Thomas M.