感染性角膜炎466例共焦显微镜检查结果临床分析

目的：探讨共焦显微镜在感染性角膜炎的病原学诊断上的意义。
　　方法：回顾性病例系列研究。对2010-01/2013-12共466例467眼感染性角膜炎共焦显微镜的检查结果进行回顾性分析，总结其共焦显微镜图像特点及各类型角膜炎的临床特征。
　　结果：患者466例平均54.4±13.0岁，男264例(56.7%)，女202例(43.3%)，诊断为真菌性角膜炎190例(40.8%)，病毒性角膜炎148例(31.8%)，细菌性角膜炎125例(26.8%)，棘阿米巴角膜炎3例(0.6%)，真菌性角膜炎可见大量真菌菌丝，棘阿米巴角膜炎可见典型阿米巴包囊。
　　结论：共焦显微镜是一种早期辅助诊断感染性角膜炎的有效方法，尤其对真菌及棘阿米巴角膜炎的早期诊断具有特异性，有利于感染性角膜炎的早期诊断及指导治疗。

Clinical features and confocal microscopic imaging characteristics of 466 cases with infectious keratitis

AIM: To observe the role of confocal microscopy in infectious keratitis management.

METHODS:Totally 466 patients(467 eyes)diagnosed as infectious keratitis from January 2010 to December 2013 were retrospectively studied. the corneas were examined early by in vivo confocal microscopy. The characteristics of their images and clinical features were studied and summarized.

RESULTS:All patients were recorded, the average age was 54.4±13.0 years, in which 264 cases(56.7%)were male, and 202 cases(43.3%)were female. In the 466 patients, 190(40.8%)were fungal keratitis, 148(31.8%)were viral keratitis, 125(26.8%)were bacterial keratitis and 3(0.6%)were acanthamoeba keratitis. There were fungal hyphae in the images of fungal keratitis. Amebic cysts were found in acanthamoeba keratitis.

CONCLUSION:Confocal microscope can help the early diagnose and treatment of infectious keratitis. It is a noninvasive imaging technique that provides high resolution images of ocular structures at a cellular level and infectious keratitis represents one of its most important clinical uses.