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目的 研究利用眼科用共焦显微镜鉴别诊断不同真菌性角膜炎的可行性。方法１８只新西兰白兔均分为３组，右眼分别接种白色念珠菌、烟曲霉菌和腐皮镰刀菌。接种时，去除角膜中央区５ｍｍ直径的上皮，滴新鲜培养的１×１０７个细胞／ｍｌ的白色念珠菌悬浮液，或涂上新鲜培养的烟曲霉菌或腐皮镰刀菌孢子，盖上软性接触镜，行睑裂缝合。在角膜感染后的第５，１０和１５天时，行共焦显微镜检查、真菌涂片检查和病理切片检查。结果 感染早期（１～５天）炎症反应明显，中期（５～１０天）炎症逐渐减轻，１０～１５天角膜形成疤痕而自愈。烟曲霉菌和腐皮镰刀菌的病程较迁延，反应较白色念珠菌重。共焦显微镜下，感染的白色念珠菌早期主要呈现芽孢状，成高亮度结构，以后发展成具有大量分支的树枝状结构，再发展成链状结构。感染１０天后未见任何真菌结构。烟曲霉菌的菌丝在早期则呈较白色念珠菌菌丝粗但分支相对较少的明亮的树枝状结构。中期以后其分支减少并变长，它在角膜组织中保留的时间较白色念珠菌长。在感染早期，腐皮镰刀菌则表现为蚯蚓状结构，以后发展为分支很少的粗短树枝状结构，其分支在３种真菌中最少但直径最粗。真菌涂片和组织学检查的结果与共焦显微镜检查相符。结论 共焦显微镜检查对真菌性角
Objective To study the feasibility of using ophthalmic confocal microscopy to differentiate different fungal keratitis. Methods Eighteen New Zealand white rabbits were divided into three groups. The right eye was inoculated with Candida albicans, Aspergillus fumigatus and Fusarium solani respectively. At the time of inoculation, the 5 mm diameter epithelium in the central cornea was removed, and freshly cultured suspension of Candida albicans at 1 × 10 7 cells / ml or spore of fresh Aspergillus fumigatus or Fusarium graminearum was coated with soft Contact lenses, palpebral fold joint. Confocal microscopy, fungal smear and biopsy were performed on days 5, 10 and 15 after corneal infection. The results of early infection (1 to 5 days) inflammatory response was obvious, the medium (5 to 10 days) inflammation gradually reduced, 10 to 15 days corneal scar formation and self-healing. Aspergillus fumigatus and Fusarium pathogens more delay in the course of response than Candida albicans. Under the confocal microscope, Candida albicans inoculated mainly showed spore shape and high brightness structure in the early stage, and later developed into a dendritic structure with a large number of branches and then developed into a chain structure. No fungal structure was seen after 10 days of infection. Aspergillus fumigatus mycelium early in the Candida albicans mycelium is relatively thick branches but relatively few bright dendritic structures. Its interphase reduces and lengthens its length and retains its corneal tissue longer than C. albicans. In the early stage of infection, Fusarium solani showed the earthworm-like structure and later developed into a short and short dendritic branch with few branches but the thickest of the three fungi. Fungal smear and histological examination of the results and confocal microscopy. Conclusions Confocal microscopy on fungal horn