{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T20:12:40Z","timestamp":1785787960896,"version":"3.56.0"},"reference-count":9,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,11,23]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>A male patient in his 20s, suffering from a persistent, infection-related corneal endothelial plaque (EP) was urgently referred to our tertiary medical centre for therapeutic penetrating keratoplasty (TPK). Over the preceding month, he had been undergoing treatment with both topical and oral antifungal medications due to clinical suspicion of fungal keratitis. At our centre, an endothelial scraping was performed using a reverse Sinskey hook to obtain samples for microbiology and revealed septate branching fungal hyphae. After targeted therapy with intracameral and intrastromal voriconazole injections, the EP healed with scarring and a final visual acuity of 20\/30 was achieved. This highlights efficacy of the reverse endothelial scraping technique (REST) in obtaining microbiological samples from corneal EPs, facilitating targeted medical treatment and averting the need for invasive procedures like penetrating keratoplasty in young patients.<\/jats:p>","DOI":"10.1136\/bcr-2024-260011","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T22:55:14Z","timestamp":1735080914000},"page":"e260011","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Reverse endothelial scraping technique (REST) for an infectious corneal endothelial plaque"],"prefix":"10.1136","volume":"17","author":[{"given":"Sonali","family":"Mehta","sequence":"first","affiliation":[{"name":"Cornea and anterior segment services, Dr Shroff's Charity Eye Hospital, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha","family":"Acharya","sequence":"additional","affiliation":[{"name":"Cornea and anterior segment services, Dr Shroff's Charity Eye Hospital, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virender Singh","family":"Sangwan","sequence":"additional","affiliation":[{"name":"Cornea and anterior segment services, Dr Shroff's Charity Eye Hospital, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arpan","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Dr Shroff's Charity Eye Hospital Delhi, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,12,24]]},"reference":[{"key":"2025082722094567000_17.12.e260011.1","doi-asserted-by":"crossref","first-page":"101","DOI":"10.18231\/2581-5016.2018.0025","article-title":"Study of the clinico-etiological profile of fungal keratitis in a tertiary care hospital in North India","volume":"4","author":"Upadhyay","year":"2020","journal-title":"IJOOO"},{"key":"2025082722094567000_17.12.e260011.2","doi-asserted-by":"crossref","DOI":"10.1155\/2020\/6083854","article-title":"Endothelial Plaques as Sign of Hyphae Infiltration of Descemet\u2019s Membrane in Fungal Keratitis","volume":"2020","author":"Qi","year":"2020","journal-title":"J Ophthalmol"},{"key":"2025082722094567000_17.12.e260011.3","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1111\/j.1442-9071.1994.tb00775.x","article-title":"Suppurative corneal ulceration in Bangladesh. A study of 142 cases examining the microbiological diagnosis, clinical and epidemiological features of bacterial and fungal keratitis","volume":"22","author":"Dunlop","year":"1994","journal-title":"Aust N Z J Ophthalmol"},{"key":"2025082722094567000_17.12.e260011.4","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1097\/ICO.0000000000001286","article-title":"Observation of Retrocorneal Plaques in Patients With Infectious Keratitis Using Anterior Segment Optical Coherence Tomography","volume":"36","author":"Takezawa","year":"2017","journal-title":"Cornea"},{"key":"2025082722094567000_17.12.e260011.5","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1097\/ICO.0000000000002912","article-title":"Clinical Observation of Corneal Endothelial Plaques With Fungal and Bacterial Keratitis by Anterior Segment Optical Coherence Tomography and In Vivo Confocal Microscopy","volume":"41","author":"Jin","year":"2022","journal-title":"Cornea"},{"key":"2025082722094567000_17.12.e260011.6","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1097\/ICO.0000000000001666","article-title":"Etiology of Global Corneal Blindness and Current Practices of Corneal Transplantation: A Focused Review","volume":"37","author":"Mathews","year":"2018","journal-title":"Cornea"},{"key":"2025082722094567000_17.12.e260011.7","doi-asserted-by":"crossref","first-page":"249","DOI":"10.4103\/JOCO.JOCO_113_20","article-title":"Delhi Infectious Keratitis Study: Update on Clinico-Microbiological Profile and Outcomes of Infectious Keratitis","volume":"32","author":"Acharya","year":"2020","journal-title":"J Curr Ophthalmol"},{"key":"2025082722094567000_17.12.e260011.8","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1097\/ICO.0000000000002626","article-title":"Endothelial Biopsy for the Diagnosis and Management of Culture-Negative Retrocorneal Fungal Keratitis With the Assistance of Optical Coherence Tomography Imaging","volume":"40","author":"Palioura","year":"2021","journal-title":"Cornea"},{"key":"2025082722094567000_17.12.e260011.9","doi-asserted-by":"publisher","DOI":"10.4103\/0301-4738.53051"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-260011","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:09:54Z","timestamp":1756357794000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-260011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":9,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,24]]},"published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1136\/bcr-2024-260011"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-260011","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}