Rose Bengal Photodynamic Antimicrobial Therapy for Patients With Progressive Infectious Keratitis: A Pilot Clinical Study

Naranjo, Andrea; Arboleda, Alejandro; Martínez, J.; Durkee, Heather; Aguilar, M.; Relhan, Nidhi; Nikpoor, Neda; Galor, Anat; Dubovy, Sander R.; Leblanc, Roger M.; Flynn, Harry W.; Miller, Darlene; Parel, Jean Marie; Amescua, Guillermo

doi:10.1016/j.ajo.2019.08.027

Cited by 63 publications

(41 citation statements)

References 38 publications

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“…20 The effect and toxicity of RB in corneal crosslinking has also been well established in preclinical studies, 11,21 and experience with RB plus green light is being accumulated in human studies. [6][7][8] After crosslinking, it causes cell death in the cornea comparable to the approved and clinically widely used riboflavin and UV corneal crosslinking. 5 Yet, there is no data on arginine and RB in combination.…”

Section: Discussionmentioning

confidence: 99%

“…25 One advantage of Rose Bengal is its long history of use in human corneal tissue, several demonstrated lightinitiated corneal applications in preclinical studies, and recent clinical studies in human patient's cornea. [6][7][8] In summary, RB-photosensitized crosslinking in the absence of oxygen can be enhanced by electron donors to produce the same level of stiffness exhibited in the presence of oxygen. A systematic evaluation of treatment parameters led to an optimization and a greater photochemical understanding of the described method.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] Recently, the first uses of RB photosensitization in a human patient's cornea was reported. [6][7][8] The treatment halted a sightthreatening case of fusarium keratitis and, 16 months later, the cornea showed a persistent demarcation line in optical coherence tomography (OCT), a classical sign of corneal crosslinking. 7 RB photosensitization differs from conventional riboflavin crosslinking in several ways.…”

Section: Introductionmentioning

confidence: 99%

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Arginine as an Enhancer in Rose Bengal Photosensitized Corneal Crosslinking

Wertheimer

Mendes

Pei

et al. 2020

Trans. Vis. Sci. Tech.

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Oxygen-independent cornea crosslinking (CXL) using rose bengal (RB) and green light may have unique clinical applications. These studies were designed to gain insight into the arginine (arg)-enhanced anaerobic crosslinking process, to maximize crosslinking efficiency, and to test a clinically feasible method for oxygen-free CXL. Methods: Rabbit corneas were treated ex vivo using 1 mM RB and 532 nm light. RB photodecomposition, monitored by absorption spectrophotometry, was used to optimize arg concentration and to develop an irradiation and re-dying protocol. The minimal effective green light fluence was identified by linear tensile strength measurements. RB penetration into the stroma was determined by fluorescence microscopy. To favor the anaerobic pathway, a contact lens was used to minimize stromal oxygen level during irradiation. Stromal cell toxicity was evaluated by a terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL) assay. Results: RB photodecomposition reached 75% of its maximal effect at 200 mM arg and the optimal fluence increment was 32.7 J/cm 2. The minimal effective fluence for cornea stiffening was 65.4 J/cm 2. Placement of a contact lens promoted oxygen-independent cornea stiffening, similar to that obtained on isolated, oxygen-deprived cornea. RB penetration into the stroma with arg present was limited to ∼120 μm, about 25% deeper than without arg. Stromal cell toxicity was limited to the depth of RB and arg penetration. Conclusions: An oxygen-independent pathway in cornea for RB-CXL was characterized and optimized, including a possible clinical protocol for its use. Translational Relevance: Oxygen-independent RB-CXL is an efficient and effective process that can be developed further for unique clinical applications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Arginine as an Enhancer in Rose Bengal Photosensitized Corneal Crosslinking

Wertheimer

Mendes

Pei

et al. 2020

Trans. Vis. Sci. Tech.

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“…Вопервых, молекулы красителей флуоресцеинового ряда широко применяются в медицине как в качестве контрастных веществ, так и в фотодинамической терапии, в частности, для лечения меланомы [18]. Имея высокие квантовые выходы генерации синглетного кислорода, эти красители становятся потенциальными фотосенсибилизаторами для нового направления фотодинамической терапии -антимикробной фотодинамической терапии [19][20][21]. Во-вторых, представленный ряд флуорофоровых красителей характеризуется последовательным замещением атомов водорода атомами галогенов (бром, йод и хлор), которое позволяет плавно варьировать их физико-химическими свойствами перераспределением зарядов между атомами, изменением электронных и пространственных структур и др.…”

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Фотофизические Процессы В Молекулах Галогенпроизводных Флуоресцеина В Анионных Обратных Мицеллах

Волкова¹,

Кулешова²,

Корватовский³

et al. 2020

Журнал Технической Физики

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Studies of photophysical processes in aqueous micellar solutions of halogen derivatives of fluorescein: Eosin( E), Erythrosin (ER) and Bengal Rose (BR) by methods of dynamic light scattering, stationary and time-resolved fluorescence spectroscopy were carried out. It was found that the introduction of dye molecules into reverse AOT micelles causes an increase in their hydrodynamic radii Rh. The time-resolved fluorescence of the studied dye molecules in reverse micelles was measured. A decrease in the average time of the excited state with an increase in Rh for E, ER, and BR was found, which is associated with an increase in the mobility of water molecules and a decrease in the effect of geometric restriction of dye molecules. The degrees of anisotropy of the fluorescence r of dye molecules in reverse micelles were measured. It was shown that in micellar systems r is greater than in aqueous solutions and decreases with increasing Rh. The rotational correlation time for the studied dye molecules in micellar systems is determined, which decreases for all the studied dyes with an increase in Rh, indicating a decrease in the microviscosity of the confined aqueous medium inside the micelle. In this case , i.e., the value of the time of the rotational correlation is affected by the "heavy atom effect".

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Clinical Features and Treatment Outcomes of Carbapenem-Resistant Pseudomonas aeruginosa Keratitis

Tribin,

Lieux,

Maestre-Mesa

et al. 2024

JAMA Ophthalmol

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ImportanceEvaluation of the microbiological diagnostic profile of multidrug-resistant Pseudomonas aeruginosa keratitis and potential management with rose bengal–photodynamic antimicrobial therapy (RB-PDAT) is important.ObjectiveTo document the disease progression of carbapenemase-resistant P aeruginosa keratitis after an artificial tear contamination outbreak.Design, Setting, and ParticipantsThis retrospective observation case series included 9 patients 40 years or older who presented at Bascom Palmer Eye Institute and had positive test results for multidrug-resistant P aeruginosa keratitis between January 1, 2022, and October 31, 2023.Main Outcomes and MeasuresEvaluation of type III secretion phenotype, carbapenemase-resistance genes blaGES and blaVIM susceptibility to antibiotics, and in vitro and in vivo outcomes of RB-PDAT against multidrug-resistant P aeruginosa keratitis.ResultsAmong the 9 patients included in the analysis (5 women and 4 men; mean [SD] age, 73.4 [14.0] years), all samples tested positive for exoU and carbapenemase-resistant blaVIM and blaGES genes. Additionally, isolates were resistant to carbapenems as indicated by minimum inhibitory concentration testing. In vitro efficacy of RB-PDAT indicated its potential application for treating recalcitrant cases. These cases highlight the rapid progression and challenging management of multidrug-resistant P aeruginosa. Two patients were treated with RB-PDAT as an adjuvant to antibiotic therapy and had improved visual outcomes.Conclusions and RelevanceThis case series highlights the concerning progression in resistance and virulence of P aeruginosa and emphasizes the need to explore alternative therapies like RB-PDAT that have broad coverage and no known antibiotic resistance. The findings support further investigation into the potential effects of RB-PDAT for other multidrug-resistant microbes.

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Rose Bengal Photodynamic Antimicrobial Therapy for Patients With Progressive Infectious Keratitis: A Pilot Clinical Study

Cited by 63 publications

References 38 publications

Arginine as an Enhancer in Rose Bengal Photosensitized Corneal Crosslinking

Arginine as an Enhancer in Rose Bengal Photosensitized Corneal Crosslinking

Фотофизические Процессы В Молекулах Галогенпроизводных Флуоресцеина В Анионных Обратных Мицеллах

Clinical Features and Treatment Outcomes of Carbapenem-Resistant Pseudomonas aeruginosa Keratitis

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