Evidence map›Paper›PMID 31171825›Full record

ArticleScientific reports2019

Cellular morphological changes detected by laser scanning in vivo confocal microscopy associated with clinical outcome in fungal keratitis.

Jaya D Chidambaram, Namperumalsamy V Prajna, Srikanthi Palepu, Shruti Lanjewar, Manisha Shah, Shanmugam Elakkiya, Prajna Lalitha, David Macleod, Matthew J Burton

Open access · goldAbstract read
In one paragraph

Article in Scientific reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.0field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 13 citations in OpenAlex.

  1. Beyond the surface: a comprehensive review of corneal endotheliitis.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Review
  2. Pathogens (Basel, Switzerland) · 2026
    Article
  3. Article
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

Jaya D ChidambaramLondon School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. Jaya.Chidambaram@Lshtm.ac.uk.ORCID http://orcid.org/0000-0001-5438-2858
Namperumalsamy V PrajnaAravind Eye Hospital, 1 Anna Nagar, Madurai, 625 020, Tamil Nadu, India.
Srikanthi PalepuAravind Eye Hospital, 1 Anna Nagar, Madurai, 625 020, Tamil Nadu, India.
Shruti LanjewarAravind Eye Hospital, 1 Anna Nagar, Madurai, 625 020, Tamil Nadu, India.
Manisha ShahAravind Eye Hospital, 1 Anna Nagar, Madurai, 625 020, Tamil Nadu, India.
Shanmugam ElakkiyaAravind Medical Research Foundation, Kuruvikaran Salai, Anna Nagar, Shenoy Nagar, Madurai, 625020, Tamil Nadu, India.
Prajna LalithaAravind Eye Hospital, 1 Anna Nagar, Madurai, 625 020, Tamil Nadu, India.
David MacleodLondon School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Matthew J BurtonLondon School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Aravind Eye Hospital · INUniversity of London · GB

Funding

Medical Research Council MR/R010161/1Wellcome Trust 097437/Z/11/ZWellcome Trust 207472/Z/17/Z
6 · The paper itself

Abstract

HRT3 in vivo confocal microscopy (IVCM) images may indicate clinical outcome, but few studies have analysed this in fungal keratitis (FK). Adults with FK (diameter ≥3 mm) presenting to Aravind Eye Hospital, India from 2012-3 were enrolled prospectively. IVCM was performed at baseline, days 7, 14 and 21 post-enrolment (+/- 3 days where possible). Specific morphologies were identified in IVCM images by a grader masked to microbiology and clinical outcome (defined as good: healed/improving, or poor: enlarged ulcer, perforation or transplant/glue). Associations with final visit outcome assessed using logistic regression. 143 FK participants were enrolled; 87 had good outcome, 56 had poor outcome. Poor outcomes were associated with stellate interconnected cellular processes with no visible nuclei (OR 2.28, 95% CI: 1.03-5.06, p = 0.043) in baseline IVCM images, and fungal filaments (OR 6.48, 95% CI:2.50-16.78, p < 0.001) or honeycomb distribution of inflammatory cells (OR 5.24, 95% CI: 1.44-19.06, p = 0.012) in final visit images. Fungal filaments (OR 3.61, 95% CI:1.64-7.95, p = 0.001), stromal dendritiform cells (OR 2.88, 95% CI:1.17-7.11, p = 0.022), or stellate cellular processes with no visible nuclei (OR 2.09, 95% CI:1.14-3.82, p = 0.017) were associated with poor outcome if not in baseline but present in final visit images. IVCM can reveal morphological changes associated with clinical outcome.

Indexed as

AcanthamoebaAdultAspergillusCell NucleusCorneaCorneal UlcerEye Infections, FungalFemaleHumansIndiaInflammationKeratitisMaleMicroscopy, ConfocalMiddle AgedOdds Ratio

Identifiers

PMID31171825
PMCPMC6554396
OpenAlexW2948027702

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.