CAJ | 학술논문

目的对非典型的真菌性角膜溃疡患者(角膜刮片取材,涂片镜检不能确诊的真菌性角膜溃疡),采用暗场显微镜联合角膜激光共焦显微镜检查进行观察研究,并归纳总结其临床特点.方法 23例(23只眼)非典型的真菌性角膜溃疡患者,在角膜刮片取材培养前采用激光角膜共焦显微镜对溃疡灶进行活体检查,然后进行角膜刮片取材,涂片常规镜检和暗场显微镜检查,研究其图象特点,并进行对比研究.结果非典型真菌性角膜溃疡灶中的真菌菌丝在活体角膜激光共焦显微镜中结构不完整、成像不清晰；在常规镜检下,成像不清甚至难以成像；但采用暗场显微镜检查能发现清晰的真菌菌丝.结论暗场显微镜观察非典型真菌性角膜溃疡有着独特的优点,该方法联合常规涂片镜检及共焦显微镜检查能提高对非典型真菌性角膜溃疡的诊断水平.
목적 대비전형적진균성각막궤양환자(각막괄편취재,도편경검불능학진적진균성각막궤양),채용암장현미경연합각막격광공초현미경검사진행관찰연구,병귀납총결기림상특점.방법 23례(23지안)비전형적진균성각막궤양환자,재각막괄편취재배양전채용격광각막공초현미경대궤양조진행활체검사,연후진행각막괄편취재,도편상규경검화암장현미경검사,연구기도상특점,병진행대비연구.결과 비전형진균성각막궤양조중적진균균사재활체각막격광공초현미경중결구불완정、성상불청석；재상규경검하,성상불청심지난이성상；단채용암장현미경검사능발현청석적진균균사.결론 암장현미경관찰비전형진균성각막궤양유착독특적우점,해방법연합상규도편경검급공초현미경검사능제고대비전형진균성각막궤양적진단수평.
Objective To observe the atypical fungal corneal ulcers by using dark field microscopy combined with in vivo laser confocal microscnpy,and to summarize the clinical characteristics.Methods Twenty-three patients (23 eyes) with atypical fungal corneal ulcer were examined by in vivo laser confocal microscopy,and then scraped the corneal ulcer and smeard,were examined by regular bright field microscopy and Dark field microscopy.The characteristics of their images were studied and compared.Results The fungal hyphae of atypical fungal corneal ulcer using in vivo laser confocal microscopy were not complete,and the imagings were not clear.The images of fungal hyphae were unclear or difficult to diagnose in conventional microscopy.However,the clear fungal hyphae can be found by dark field microscopy.Conclusions There are unique advantage of dark field microscope that the fungal pyphae of atypical fungal corneal ulcer are observed.The dark field microscope,laser confocal microscopy and routine smear microscope can improve the diagnosis levels of atypical fungal corneal ulcer.