What question did this study set out to answer?

This study aims to evaluate the diagnostic roles of IVCM and AS-OCT in monitoring infectious keratitis.

June 11, 2026Open Access

The combined use of in vivo confocal microscopy and optical coherence tomography in monitoring corneal infections

Key Points

This study aims to evaluate the diagnostic roles of IVCM and AS-OCT in monitoring infectious keratitis.
Prospective examination of 35 eyes with severe infectious keratitis using various imaging techniques.
Analyzed imaging parameters like cellular infiltration, nerve presence, and microbial features.
Performed quantitative measurements and statistical comparisons between imaging modalities.
IVCM revealed high sensitivity in detecting fungal filaments and Acanthamoeba cysts.
AS-OCT accurately measured infiltrate depth and corneal thickness.
Significant differences in keratocyte density were observed, with notably lower densities in Acanthamoeba keratitis.

Abstract

Abstract Background/Aims Infectious keratitis (IK) is a major cause of blindness worldwide, requiring prompt diagnosis and management. This study evaluates the diagnostic and evaluative roles of in vivo confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT) in acute IK through correlating the characteristic imaging features of both modalities. Materials and methods In this prospective study, 35 eyes with severe IK of bacterial, fungal, Acanthamoeba, or mixed origin were examined using slit lamp biomicroscopy, microbiological culture, AS-OCT, and IVCM during the acute phase. Imaging parameters including tissue integrity, cellular infiltration, nerve presence, vascularisation, and microbial features were analysed. Quantitative cell density measurements and structural assessments were performed, with statistical comparisons between modalities and pathogen groups. Results IVCM effectively visualised cellular details, including keratocytes, inflammatory cells, nerve fibres, and specific organisms, with high sensitivity for detecting fungal filaments and Acanthamoeba cysts. AS-OCT provided high-resolution cross-sectional images, accurately measuring infiltrate depth, corneal thickness, and neovascularisation. IVCM was superior in identifying microbial elements, whereas AS-OCT excelled in assessing tissue architecture and oedema. Significant differences in cell densities were observed among pathogens, notably lower keratocyte density in Acanthamoeba keratitis. Both modalities were complementary, enhancing disease characterisation and monitoring. Conclusions IVCM and AS-OCT are valuable, non-invasive tools that provide critical insights into IK. Their combined application improves early diagnosis, detailed evaluation, and treatment monitoring. Integration with artificial intelligence holds promise for further advances in precise, rapid diagnosis and personalised management of infectious keratitis.

KI fragen

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