Diagnostic armamentarium of infectious keratitis: A comprehensive review

Ocul Surf. 2022 Jan:23:27-39. doi: 10.1016/j.jtos.2021.11.003. Epub 2021 Nov 13.

Abstract

Infectious keratitis (IK) represents the leading cause of corneal blindness worldwide, particularly in developing countries. A good outcome of IK is contingent upon timely and accurate diagnosis followed by appropriate interventions. Currently, IK is primarily diagnosed on clinical grounds supplemented by microbiological investigations such as microscopic examination with stains, and culture and sensitivity testing. Although this is the most widely accepted practice adopted in most regions, such an approach is challenged by several factors, including indistinguishable clinical features shared among different causative organisms, polymicrobial infection, long diagnostic turnaround time, and variably low culture positivity rate. In this review, we aim to provide a comprehensive overview of the current diagnostic armamentarium of IK, encompassing conventional microbiological investigations, molecular diagnostics (including polymerase chain reaction and mass spectrometry), and imaging modalities (including anterior segment optical coherence tomography and in vivo confocal microscopy). We also highlight the potential roles of emerging technologies such as next-generation sequencing, artificial intelligence-assisted platforms. and tele-medicine in shaping the future diagnostic landscape of IK.

Keywords: Artificial intelligence; Confocal microscopy; Corneal infection; Corneal ulcer; Diagnosis; Mass spectrometry; Next-generation sequencing; Polymerase chain reaction.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Artificial Intelligence*
  • Cornea
  • Humans
  • Keratitis* / diagnosis
  • Keratitis* / microbiology
  • Tomography, Optical Coherence