Deciphering infectious uveitis etiology: Immune cell profiling in keratic precipitates using in vivo confocal microscopy

Bibliographic Details
Title: Deciphering infectious uveitis etiology: Immune cell profiling in keratic precipitates using in vivo confocal microscopy
Authors: Fang Fang, Yanbing Wang, Yangyan Xiao, Huiling Li, Jiao Tian
Source: Heliyon, Vol 10, Iss 21, Pp e39211- (2024)
Publisher Information: Elsevier, 2024.
Publication Year: 2024
Collection: LCC:Science (General)
LCC:Social sciences (General)
Subject Terms: Keratic precipitates, Immune cells, Uveitis, Confocal microscopy, Science (General), Q1-390, Social sciences (General), H1-99
More Details: Purpose: To elucidate the etiology of infectious uveitis through the comprehensive analysis of keratic precipitates (KPs) using in vivo confocal microscopy (IVCM). Design: Cross-sectional, observational case series. Methods: This single-center, cross-sectional study was conducted at a tertiary care eye hospital from January 2021 to October 2023. It involved a detailed ophthalmologic evaluation of all subjects and included a total of 46 eyes from 36 subjects who were diagnosed with infectious uveitis. IVCM, specifically utilizing the HRT II Rostock corneal module, was employed to study the biomicroscopic morphology of KPs. The categorization of KPs was based on cell size, morphology, and reflection. Results: Cells of KPs were assessed for size, morphology, and reflection through in vivo confocal microscopy. Patients, ranging in age from 13 to 80 years (median 51 years), exhibited diverse morphologic forms of KPs. Neutrophil-dominated KPs with uniform size were predominantly observed in bacterial and fungal endophthalmitis cases (19/19, 100 %), accompanied by small numbers of mononuclear-macrophages in three eyes (3/19, 15.8 %). Viral uveitis cases displayed a broader array of immune cell types, including characteristic striated or dendritic cells in all eyes (27/27, 100 %). Lymphocytes were commonly present (24/27, 88.9 %), forming clusters in sixteen eyes and dispersed in the corneal endothelium below the midline in eight eyes. Neutrophil infiltration was notable in three cytomegalovirus-infected eyes (3/27, 11.1 %). A marked increase in sub-basal corneal epithelial Langhans cells was associated with viral uveitis. Conclusions: Neutrophil-dominated KPs strongly indicate endogenous bacterial or fungal endophthalmitis, while the presence of dendritic cells and lymphocytes in KPs is suggestive of viral uveitis. In vivo confocal microscopy emerges as a crucial tool for differentiating the etiologic diagnosis of infectious uveitis.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2405-8440
Relation: http://www.sciencedirect.com/science/article/pii/S2405844024152425; https://doaj.org/toc/2405-8440
DOI: 10.1016/j.heliyon.2024.e39211
Access URL: https://doaj.org/article/9e4e3f40964148379d076fa2f24850c6
Accession Number: edsdoj.9e4e3f40964148379d076fa2f24850c6
Database: Directory of Open Access Journals
More Details
ISSN:24058440
DOI:10.1016/j.heliyon.2024.e39211
Published in:Heliyon
Language:English