Apport de la microscopie confocale in vivo au diagnostic des kératites amibiennes

Diagnosing and monitoring the characteristics of Acanthamoeba keratitis using slit scanning and laser scanning in vivo confocal microscopy

“…The double wall cyst was the most commonly encountered cyst type and overall AK sign described in the literature on IVCM, with 65% of the studies describing it or demonstrating it in their images (Figure 2a). Many of the authors described the double wall cyst as a hyper‐reflective or high contrast round, ovoid structure or highly refractive body with a bilayered or double‐walled appearance 2,24,25,29–34 . Some authors described the double wall cyst shape as polygonal 35–37 .…”

“…Most of the studies which included trophozoites in their images or descriptions described them as being irregular, pear‐ or wedge‐shaped and hyper‐reflective with spindle shapes projecting from the surface, representing acanthopodia or pseudopods (Figure 2j,k). 24,25,29,32,33,47,53 Most of the studies observed trophozoite sizes between 20 and 60 μm 24,30,32,36,39,53,54 ; however, Hung et al 29 . reported trophozoites sizes between 10 and 20 μm while Matsumoto et al.…”

“…Many of the authors described the double wall cyst as a hyper-reflective or high contrast round, ovoid structure or highly refractive body with a bilayered or double-walled appearance. 2,24,25,[29][30][31][32][33][34] Some authors described the double wall cyst shape as polygonal. [35][36][37] The size of the double wall cyst was measured consistently between 10 and 30 microns (μm) in every study.…”

“…Most of the studies which included trophozoites in their images or descriptions described them as being irregular, pear-or wedge-shaped and hyper-reflective with spindle shapes projecting from the surface, representing acanthopodia or pseudopods (Figure 2j,k). 24,25,29,32,33,47,53 Most of the studies observed trophozoite sizes between 20 and 60 μm 24,30,32,36,39,53,54 ; however, Hung et al 29 reported trophozoites sizes between 10 and 20 μm while Matsumoto et al reported sizes over 100 μm. 55 Objects highly associated with AK Other objects highly associated with AK were divided into five groups: rod-shaped objects, spindle-shaped objects, polygonal stellate shaped objects, honeycomb pattern keratocytes and large hyper-reflective objects >30 μm in size which were found in 2%, 8%, 8%, 6% and 2% of the studies included in this review, respectively (Figure 2l-o).…”

Diagnosis of Acanthamoeba keratitis

“…Как подчеркивает Н. Kaufman, КМ ярко выявляет и другой важный диагностиче-ский признак АК -кератоневрит, утолщенные нервные стволы и белые линии вдоль нервов как реакцию на нейротропность амеб [21]. Однако визу-ализация с высоким разрешением может быть за-труднена из-за световых рефлексов, особенно при нарушении прозрачности роговицы [54]. Исследо-вание имеет высокую чувствительность (92,9-100%) и специфичность (77,3-100%), но требует высокой квалификации оператора [55].…”