biostudies-literatureUnknown15(1)Przybek-Skrzypecka JIn vivo confocal microscopy (IVCM) offers a non-invasive, rapid method for diagnosing Acanthamoeba keratitis (AK) by detecting cysts or trophozoites in the initial clinic visit images. In this retrospective observational study, we reviewed HRT3 IVCM images from patients presenting to Manchester Royal Eye Hospital with clinically- suspected AK for IVCM morphological features (IVCM-MF) of both Acanthamoeba and corneal cells. Twenty-seven patients were included in the study: median age 29 years (range 16-71 years), female gender (59%; n = 16/27) and contact lens wear as the main risk factor. Median symptom duration before the initial ophthalmologist visit was 9 days (range 2 to 42 days). IVCM had a higher detection rate for AK in 85% of patients (n = 23/27), with culture positivity in only 74Scientific reports10940https://www.ebi.ac.uk/biostudies/studies/S-EPMC11954979biostudies-literatureDiagnostic features of Acanthamoeba keratitis via in vivo confocal microscopy.PMC11954979Chidambaram JDPrzybek-Skrzypecka JCarley FBrahma AArmstrong MKim JWalkden AAu LfalseDiagnostic features of Acanthamoeba keratitis via in vivo confocal microscopy.In vivo confocal microscopy (IVCM) offers a non-invasive, rapid method for diagnosing Acanthamoeba keratitis (AK) by detecting cysts or trophozoites in the initial clinic visit images. In this retrospective observational study, we reviewed HRT3 IVCM images from patients presenting to Manchester Royal Eye Hospital with clinically- suspected AK for IVCM morphological features (IVCM-MF) of both Acanthamoeba and corneal cells. Twenty-seven patients were included in the study: median age 29 years (range 16-71 years), female gender (59%; n = 16/27) and contact lens wear as the main risk factor. Median symptom duration before the initial ophthalmologist visit was 9 days (range 2 to 42 days). IVCM had a higher detection rate for AK in 85% of patients (n = 23/27), with culture positivity in only 742025-01-01T00:00:00Z2025 Mar2025-07-09T03:04:25.783Z2025-07-09T03:04:25.783ZS-EPMC119549794015797310.1038/s41598-025-94567-0