Abstract

P 143

Diagnostic of corneal pathologies with confocal laser scanning microscopy

Thoralf Wecke, Claudia Schuart, Manuela Hinz, Wolfgang Behrens-Baumann
Augenklinik mit Poliklinik, Otto-von-Guericke-Universität, Magdeburg

Objective
Confocal microscopy (KFM) is performed with a laserscanner, which is capable to scan tissue in several levels with a software for two and three-dimensional images.
In ophthalmology the Rostock Cornea Module (RCM) is used. The RCM has been developed in combination with the Heidelberg Engineering Retina Tomograph (HRT) by the University of Rostock.
The KFM may be helpful in description of LASIK flaps, after keratoplastics, glaucoma filtering surgery, cornea cross linking and even the differentialdiagnosis of various bacterial, viral, mycotic and parasitic infections.
Methods
To correlate slit lamp findings with confocal laser scanning microscopy in bacterial, viral, fungal and amoeboid keratitis, to show the potentialities and limitations of the KFM.
Results
In all cases of keratitis polymorphic or round inflammatory cells and so-called activated keratozytes can be demonstrated. Bacterial infections do not show any specific changes. Viral keratitis has a large number of irregular, partly binucleated epithelial cells and acellular areas near of the ending of nerves. Direct detection of viruses is not possible. In mycotic keratitis high reflective fungal hyphae and in amoeboid keratitis double-walled amoeboid cysts can be verified.
Conclusions
With the Rostock Cornea Module corneal structures for up to 1-2 microns are visible. This may help in differential diagnosis of several corneal infections, particularly mycotic and amoeboid pathogens. The RCM can be much faster in diagnostic than microbiological culture or PCR, although the microbiological testing is not replaced.

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