Related Experiment Video
Updated: Jan 16, 2026
Clarifying and Imaging Candida albicans Biofilms
Published on: March 6, 2020
Localized Versus Diffuse Corneal Invasion in Fungal Keratitis: Histological Insights from Candida albicans and
Johanna Theuersbacher1, Lukas Haug2, Alexander Maximilian Aldejohann3,4
1Department of Ophthalmology, University Hospital Würzburg, 97080 Würzburg, Germany.
Abstract:
Fungal keratitis is a severe infection that often requires surgical intervention and is associated with poor outcomes. Penetrating keratoplasty allows for the complete removal of the fungal infiltrate and thus can be a turning point in therapy. The depth of pathogen invasion, which cannot always be reliably assessed by slit lamp examination, can be accurately determined through histological analysis of the corneal trephinate. In this study, we histologically analyzed two corneal trephinates obtained during an emergency keratoplasty performed for uncontrollable mycotic infections. In case 1, caused by Candida albicans, the infiltrate remained localized at the site of pathogen entry. In contrast, in case 2, Fusarium falciforme demonstrated extensive tissue invasion, spreading destructively throughout the cornea. This invasion pattern suggests that Fusarium keratitis is difficult to control due to its aggressive spreading behavior within the tissue. This explains the high rate of penetrating keratoplasty required in such cases.
Insights
Fungal keratitis can lead to severe vision loss. Histological analysis of corneal trephinates revealed that Fusarium fungi spread aggressively, unlike Candida, explaining the need for extensive surgery like penetrating keratoplasty.
Area of Science:
- Ophthalmology
- Mycology
- Pathology
Background:
- Fungal keratitis is a severe ocular infection with poor visual outcomes.
- Penetrating keratoplasty is a surgical option for fungal keratitis, but its success depends on pathogen invasion depth.
- Histological analysis of corneal trephinates can accurately assess invasion depth, aiding treatment decisions.
Purpose of the Study:
- To compare the tissue invasion patterns of Candida albicans and Fusarium falciforme in fungal keratitis.
- To correlate histological findings with the clinical course and surgical outcomes of fungal keratitis.
Main Methods:
- Histological analysis of corneal trephinates from two patients undergoing emergency penetrating keratoplasty for fungal keratitis.
- Identification of the causative fungal species and assessment of infiltrate extent and tissue destruction.
Main Results:
- In one case, Candida albicans infiltrate was localized to the entry site.
- In the second case, Fusarium falciforme exhibited extensive, destructive invasion throughout the cornea.
- Histological findings correlated with the clinical presentation and the need for penetrating keratoplasty.
Conclusions:
- Fusarium falciforme demonstrates aggressive tissue invasion in fungal keratitis, making it difficult to control.
- Histological analysis of corneal trephinates is crucial for understanding fungal invasion patterns and guiding therapeutic strategies.
- The aggressive nature of Fusarium keratitis explains the high incidence of penetrating keratoplasty required for its management.
