Related Experiment Video
Updated: Sep 30, 2025
Use of In Vivo Imaging to Screen for Morphogenesis Phenotypes in Candida albicans Mutant Strains During Active Infection in a Mammalian Host
Published on: October 12, 2022
The use of in vivo confocal microscopy in fungal keratitis - Progress and challenges
Ingvild M Bakken1, Catherine J Jackson2, Tor P Utheim3
1Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway.
Abstract:
Fungal keratitis (FK) is a serious and sight-threatening corneal infection with global reach. The need for prompt diagnosis is paramount, as a delay in initiation of treatment could lead to irreversible vision loss. Current "gold standard" diagnostic methods, namely corneal smear and culture, have limitations due to diagnostic insensitivity and their time-consuming nature. PCR is a newer, complementary method used in the diagnosis of fungal keratitis, whose results are also sample-dependent. In vivo confocal microscopy (IVCM) is a promising complementary diagnostic method of increasing importance as it allows non-invasive real-time direct visualization of potential fungal pathogens and manifesting infection directly in the patient's cornea. In numerous articles and case reports, FK diagnosis by IVCM has been evaluated, and different features, approaches, sensitivity/specificity, and limitations have been noted. Here, we provide an up-to-date, comprehensive review of the current literature and present the authors' combined recommendations for fungal identification in IVCM images, while also looking to the future of FK assessment by IVCM using artificial intelligence methods.
Insights
Fungal keratitis (FK) diagnosis can be improved with in vivo confocal microscopy (IVCM). This review synthesizes current literature and offers recommendations for identifying fungal pathogens in IVCM images.
Area of Science:
- Ophthalmology
- Medical Mycology
- Diagnostic Imaging
Background:
- Fungal keratitis (FK) is a severe corneal infection leading to vision loss.
- Current diagnostic methods (corneal smear, culture) are insensitive and slow.
- Prompt diagnosis is critical to prevent irreversible vision impairment.
Purpose of the Study:
- To review the current literature on fungal keratitis diagnosis using in vivo confocal microscopy (IVCM).
- To provide recommendations for identifying fungal pathogens in IVCM images.
- To explore the future potential of AI in FK assessment via IVCM.
Main Methods:
- Comprehensive literature review of studies evaluating FK diagnosis by IVCM.
- Analysis of reported features, approaches, sensitivity, and specificity of IVCM.
- Synthesis of authors' combined recommendations for fungal identification in IVCM.
Main Results:
- IVCM allows non-invasive, real-time visualization of fungal pathogens in the cornea.
- Various IVCM features and approaches have been reported for FK diagnosis.
- Literature evaluation highlights the diagnostic potential and limitations of IVCM.
Conclusions:
- IVCM is a valuable complementary tool for diagnosing fungal keratitis.
- Standardized recommendations for IVCM-based fungal identification are needed.
- Artificial intelligence holds promise for enhancing FK assessment with IVCM in the future.
Related Concept Videos
01:16Confocal Fluorescence Microscopy
01:28Three-Dimensional Microscopy in Microbiology