ArticleInvestigative ophthalmology & visual science2025
Histopathological Evaluation of Corneal Tissues in Microsporidia Stromal Keratitis.
Article in Investigative ophthalmology & visual science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- PI3K/Akt Signaling as a Potential Therapeutic Target for Reducing Inflammation and Corneal Stromal Injury in Microsporidial Stromal Keratitis.Investigative ophthalmology & visual science · 2026Article
- Host Response and Pathogen Load in Acanthamoeba Keratitis: A Histopathological Analysis.Investigative ophthalmology & visual science · 2026Article
- Emerging Ocular Pathogen Resistance and Clinically Used Solutions: A Problem That Is More than Meets the Eye.Pharmaceuticals (Basel, Switzerland) · 2025Review
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: The purpose of this study was to evaluate the histopathological factors in non-resolving cases of microsporidia stromal keratitis (MSK) through the study of corneal buttons obtained during therapeutic penetrating keratoplasty (TPK). Methods: This was a retrospective noncomparative consecutive case series. This case series included 22 corneal buttons (22 patients) of histologically diagnosed MSK between June 2015 and April 2023. Records of preoperative clinical and microbiological data, and postoperative microbiological and histopathologic data of the corneal buttons were evaluated. Results: Histologic evaluation was conducted of the buttons for morphologic changes, degree and distribution of inflammatory cells, presence of microsporidial spores, and their degree and distribution within the corneal buttons. This study evaluated 22 patients with MSK, highlighting clinical, microbiological, treatment, and histopathological findings. The mean patient age was 57.1 ± 13.4 years (range = 22-83 years). The median interval from symptom onset to presentation was 4 months, and the mean time from presentation to keratoplasty was 1 month. Microsporidia spores were detected in 59% of cases through smears, with 41% of cases showing no organisms on microbiological tests. Targeted therapy using polyhexamethylene biguanide (PHMB) 0.02% was given in 13 cases, whereas 9 cases were treated empirically. Histopathology showed no significant correlation between the distribution of inflammatory cells and that of microsporidia. Moderate microsporidia severity correlated with longer symptom duration (10.0 ± 6.36 months). These findings underscore the complexity of MSK management and the variable outcomes. Conclusions: The progression of MSK in advanced stages appears to be influenced by a combination of pathogen-related factors, such as high microsporidial load with deep stromal penetration, and host-related factors, including a pronounced inflammatory response. Additionally, the limited effectiveness of topical PHMB may contribute to disease progression.
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