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[摘要]
目的：应用激光共焦显微镜观察真菌性角膜炎患者图像特点及菌丝和孢子检出率，探讨激光共焦显微镜检查在真菌性角膜炎临床诊断中的意义。
方法：对41例41眼经门诊确诊为真菌性角膜炎的患者行角膜激光共焦显微镜检查，观察不同治疗期真菌性角膜炎患者活体角膜各层图像特点。
结果：共焦显微镜下真菌性角膜炎患者图像有如下特点：(1)病变部位角膜各层形态结构破坏明显； 角膜上皮至基质不同程度水肿； 炎细胞浸润； 神经结构破坏； 基质层结构紊乱，透过度降低；(2)真菌菌丝是本病的特异性诊断依据，不同菌种感染在镜下菌丝有不同的影像学特点；(3)不同病变时期和治疗阶段，图像有很大差异，真菌菌丝的检出并不是诊断本病的唯一依据。
结论：激光共焦显微镜检查具有无创、及时等优点，在临床诊断真菌性角膜炎中有重要参考意义，尤其是指导临床早期诊断、合理治疗及评价预后。
[Key word]
[Abstract]
AIM: To examine the configuration of fungal keratitis and the detection rate of hypha and spore under confocal laser microscopy and investigate the value of confocal microscopy in the clinical diagnosis of fungal keratitis.
METHODS: We conducted laserconfocal microscopy on 41 patients of 41 eyes diagnosed as fungal keratitis and compared the configuration of different layers of cornea in different stages.
RESULTS: The fungal infected corneas histologically showed disordered layers, edema, infiltration of inflammatory cells, damaged sub-epithelial nerves and disordered stroma with reduced transparence. Hypha showed a specific base on the diagnosis of the disease, but not the only, it may appeared different configuration in different types of fungal keratitis and at different stages of the disease.
CONCLUSION:Confocal laser microscopy is a noninvasive and rapid intuitive technique, and can offer helpful analysis in the early diagnosis, reasonable treatment and prognosis evaluation of fungal keratitis.
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