Sammendrag
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.
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