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Cytological features of inflammatory cells infiltration indicates the etiology of infectious keratitis
Author(s) -
SMEDOWSKI A,
TARNAWSKA D,
WYLEGALA E
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2014.4425.x
Subject(s) - pathology , keratitis , cornea , in vivo , infiltration (hvac) , fungal keratitis , nerve plexus , medicine , cytology , corneal inflammation , corneal epithelium , inflammation , epithelium , biology , ophthalmology , immunology , physics , microbiology and biotechnology , thermodynamics
Abstract Purpose To analyze histological findings of infectious keratitis in corneal epithelium including inflammatory cells infiltrations. Methods We performed in vivo confocal microscopy (HRT III, Rostock Cornea Module) in 190 patients with diagnosed infectious keratitis of various etiology ‐ 72 viral, 66 bacterial, 34 fungal, 18 amoebal keratitis. For corneal scans we used 400x lens and 63x magnification. Microscopic analysis included inflammatory cells infiltration – number, size and shape of cells; superficial corneal nerve plexus (number and characteristics of nerve fibers) and cytology of epithelial cells. Described features were compared between groups. Results Inflammatory cells densities showed no differences between groups, however there was clearly different ratio of round/dendritic inflammatory cells, respectively 0.07, 8.0, 1.0, 1.2 for viral, bacterial, fungal and amoebal keratitis (U‐Mann Whitney test, P<0.05). Additionally inflammatory cells presented various stage of polimorphism and polimegatism depended on keratitis type. Differences were observed also in nerve fiber numbers (U‐Mann Whitney test, P<0.05) and epithelial layer architecture. Conclusion In vivo analysis of corneal epithelial histology shows high specificity and sensitivity in infectious keratitis diagnosis. Correct diagnosis of infectious keratitis is often difficult. In vivo microscopic analysis of both epithelial layer and cytology of inflammatory infiltration might provide fast and highly specific differentiation of keratitis etiology.