Herpetic keratitis after corneal collagen cross-linking with riboflavin and ultraviolet-A for keratoconus

Al-Qarni, Awad; AlHarbi, Mosa

doi:10.4103/0974-9233.159777

Cited by 30 publications

(35 citation statements)

References 11 publications

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“…This new method of treatment is however still under clinical trial. 14,15 The aims of management of a case such as this would be to treat the complication both medically and surgically, failure of which would increase the vasculature and scarring, resulting in severe visual deterioration.…”

Section: Discussionmentioning

confidence: 99%

Management of Neovascularization in Recurrent Herpetic Keratitis

2020

J Bah Med Soc

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Herpetic stromal keratitis activates a cascade of inflammatory processes that stimulate angiogenic factors such as VEGF (Vascular Endothelial Growth Factor) causing the development of blood vessels in the cornea. In this case report, we describe an unusual case of a 35-year-old man with a known history of herpetic keratitis presenting to the emergency department with pain, haziness and itchiness of the right eye due to extensive neovascularization at the inferotemporal sclera of the corneal stroma extending to the 3 o'clock position. Acyclovir, anti-VEGF (avastin) and argon laser were used in successfully managing the patient. The triple therapy reversed neovascularization and prevented its further extension, leading to a good prognosis for the patient.

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Section: Discussionmentioning

confidence: 99%

Management of Neovascularization in Recurrent Herpetic Keratitis

2020

J Bah Med Soc

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“…Infectious complications, including fungal, herpetic, Acanthamoeba , or bacterial keratitis, might be associated with epithelial defects, corticosteroid use, and infectious contamination of the cornea or the instruments used during the procedure. [4567] However, non-infectious events, reported by many authors, occur mainly due to the stimulation of immunologic responses. Sterile infiltrates are a relatively common complication after CXL that may lead to corneal transplantation in most severe cases.…”

Section: Discussionmentioning

confidence: 99%

Recurrent peripheral stromal keratitis following corneal collagen cross-linking: A case report

Faramarzi¹,

Hassanpour²,

Roshandel³

et al. 2019

J Ophthalmic Vis Res

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Purpose: Corneal collagen cross-linking (CXL) has become the standard initial intervention in eyes with progressive keratoconus (KC) that have not undergone keratoplasty. The prolonged exposure of the de-epithelialized cornea predisposes it to adverse complications, such as microbial keratitis and melting. Herein, we report a case of bilateral recurrent peripheral stromal keratitis following CXL. Case Report: We present a 29-year-old woman who complained of ocular redness and discomfort in both eyes for 4 months, and had undergone bilateral CXL 10 months before. The best spectacle corrected visual acuity (BSCVA) was 60/200 in the right and 80/200 in the left eye. Both eyes showed moderate conjunctival hyperemia, dilation, and engorgement of the perilimbal episcleral vessels. There was a peripheral corneal stromal infiltration with thinning, and an overlying epithelial defect in the right eye with a lucid interval from the limbus. She was treated with lubricating eye drops and ointments and topical corticosteroids every 4 hours for 2 weeks then slowly tapered off. Afterwards, she experienced multiple recurrences in both eyes, which were successfully managed with topical corticosteroids and lubricants. After 2 years, her BSCVA was 20/30 with −3.00-5.50 * 90 in the right eye and 20/40 with −4.00-4.50 * 90 in the left. Conclusion: Although CXL is a safe method, studies with longer follow-ups are needed to investigate the risk of rare complications.

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“…Cytospin smeared corneal epithelial cells from KC and PRK were immunostained for different molecular markers. After fixing and washing, cells were permeabilized with 0.1% Triton X-100 (Fisher Scientific, Qualigens, Mumbai, India) and stained using antibodies as previously mentioned 16. Stained cells were mounted using a VECTASHIELD containing 2-(4-amidinophenyl)-1H-indole-6-carboxamidine (Vector Laboratories, Burlingame, CA).…”

Section: Methodsmentioning

confidence: 99%

“…The adverse effects of ultraviolet-A (UV-A) irradiation on the limbal epithelial stem cells residing in the proximity of the exposed cornea has been described by several groups 13–15. Additionally, one feared complication of KC treatment with CXL is infectious keratitis secondary to nonhealing epithelium 16,17. A better understanding of the role of corneal epithelial cells in KC may help determine the optimal treatment regime of CXL to ensure a safer treatment outcome.…”

Section: Introductionmentioning

confidence: 99%

Characterization of Corneal Epithelial Cells in Keratoconus

Shetty

Vunnava

Dhamodaran

et al. 2019

Trans. Vis. Sci. Tech.

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PurposeWe studied the cellular characteristics of epithelial cells in the cone and extraconal periphery of corneas in keratoconus eyes.MethodsThis prospective observational study was conducted at Narayana Nethralaya Eye Institute. A total of 83 and 42 eyes with keratoconus and normal topography, respectively, were included in the study. Corneal epithelial cells were collected and analyzed for apoptosis, proliferation, epithelial-mesenchymal transition, and differentiation status using molecular and biochemical tools. Statistical analysis was performed using the Student's t-test.ResultsCorneal epithelial cells from the cone showed significantly higher expression of proapoptotic marker BAX (P < 0.005) compared to controls. Significantly elevated expression of cell cycle markers CYCLIN D1 (P < 0.005) and Ki67 (P < 0.005) were noted in the extraconal region compared to controls. Cells of the cone showed significantly higher ZO-1 (P < 0.005) and lower vimentin (P < 0.005) compared to controls. Significantly lower expression of the differentiation marker CK3/12 (P < 0.05) was observed in cones compared to controls.ConclusionsCones of keratoconic corneas show enhanced cell death, poor differentiation, proliferation and epithelial-mesenchymal transition. The cellular changes of the corneal epithelial cells in the cone and extraconal region differ significantly in a keratoconus corneas.Translational RelevanceCharacterization of patient-specific corneal epithelial cellular status in keratoconus has the potential to determine the optimal treatment and therapeutic outcomes paving the way towards personalized treatment in the future.

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Herpetic keratitis after corneal collagen cross-linking with riboflavin and ultraviolet-A for keratoconus

Cited by 30 publications

References 11 publications

Management of Neovascularization in Recurrent Herpetic Keratitis

Management of Neovascularization in Recurrent Herpetic Keratitis

Recurrent peripheral stromal keratitis following corneal collagen cross-linking: A case report

Characterization of Corneal Epithelial Cells in Keratoconus

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