UVA-riboflavin photochemical therapy of bacterial keratitis: a pilot study

Makdoumi, Karim; Mortensen, Jes; Sorkhabi, Omid; Malmvall, Bo‐Eric; Crafoord, Sven

doi:10.1007/s00417-011-1754-1

Cited by 160 publications

(121 citation statements)

References 49 publications

(61 reference statements)

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“…Thus, it increases resistance against microbial degradation and corneal melting (26,(35)(36) . Even though some clinical trials and experimental studies have shown improvement of fungal ulcers with CXL (21,23) , this was not observed in our study. All of our patients with fungal ulcers underwent adjuvant surgical treatment aimed at curing the infectious process.…”

Section: Discussioncontrasting

confidence: 92%

“…Makdoumi Table 3 Sample distribution according to ulcer size, area, healing time, and culture Table 4 Visual acuity before and after CXL Table 6 Type of culture, complications, and additional surgical procedures this study the lesions healed, with consequent improvement in visual acuity without the need for antibiotic therapy (23) . Martins SA et al studied the in vitro response of Staphylococcus epidermidis, Staphylococcus aureus, and Pseudomonas aeruginosa to CXL.…”

Section: Discussionmentioning

confidence: 91%

“…Studies show that therapeutic transplants represent 2.6% to 17.9% of total penetrating transplants (17) . There are reports of corneal ulcers treated successfully with corneal collagen crosslinking (CXL) (18)(19)(20)(21)(22)(23)(24)(25) . An experimental study found increased resistance to enzymatic digestion by collagenase, pepsin, and trypsin in corneas subjected to CXL (26) .…”

mentioning

confidence: 99%

“…Currently, CXL is usually indicated for cases of keratoconus (30) , pellucid marginal degeneration (31) , painful bullous keratopathy (32) , and iatrogenic ectasia after refractive surgery with laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) (30) . The therapeutic effects of CXL in infectious keratitis are still unclear (18)(19)(20)(21)(22)(23)(24)(25)(26) . This study aimed to evaluate the effect of CXL on infectious keratitis resistant to medical treatment.…”

mentioning

confidence: 99%

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Efeito terapêutico do crosslinking corneal na ceratite infecciosa

Escarião¹,

Ribeiro²,

Jorge³

et al. 2013

Rev. bras.oftalmol.

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Purpose:To evaluate the effect of corneal crosslinking (CXL) RESUMOObjetivo: Avaliar o efeito do crosslinking (CXL) no tratamento de ceratite infecciosa, resistente ao tratamento clínico, e investigar a relação com o agente etiológico. Métodos: Foram incluídos 11 pacientes com diagnóstico de ceratite infecciosa de etiologia bacteriana (sete olhos) e fúngica (quatro olhos) na Fundação Altino Ventura (FAV) no período de outubro de 2011 a maio de 2012. Os pacientes incluídos estavam em uso de colírios há pelo menos sete dias e não apresentavam melhora da infecção. Estes foram avaliados antes da realização do CXL e no período pós-operatório até cicatrização da úlcera. Para realização do CXL foram instiladas gotas de riboflavina a 0,1% e dextrano a 20%, a cada cinco minutos em um período de 30 minutos antes do procedimento, e durante a aplicação da luz ultravioleta A (UVA). A córnea foi exposta à UVA com comprimento de onda de 370ηm ± 5ηm e uma irradiância de 3mW/cm². Resultados: Os pacientes com infecção bacteriana obtiveram cura do processo infeccioso após o CXL e nenhum paciente com ceratite fúngica apresentou cicatrização. Observou-se associação significante (p = 0,003) entre o agente etiológico e a cicatrização. Conclusão: O CXL mostrou-se eficaz no tratamento da ceratite bacteriana resistente ao tratamento clínico, evitando a realização de transplante tectônico. Em relação à ceratite fúngica, este procedimento não influenciou na melhora do processo infeccioso.Descritores: Córnea; Reagentes para ligações cruzadas/uso terapêutico; Ceratite infecciosa/quimioterapia; Ceratite bacteriana/ quimioterapia; Ceratite fúngica/quimioterapia

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Section: Discussioncontrasting

confidence: 92%

Section: Discussionmentioning

confidence: 91%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Efeito terapêutico do crosslinking corneal na ceratite infecciosa

Escarião¹,

Ribeiro²,

Jorge³

et al. 2013

Rev. bras.oftalmol.

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“…Therefore, research into the development of novel therapeutic approaches is essential. In this regard photodynamic inactivation has been in experimental and clinical use throughout the last decade (6)(7)(8). Research on cystic fibrosis established an antimicrobial effect of gaseous nitric oxide (gNO) in infections with P. aeruginosa using a rat model (9).…”

Section: Introductionmentioning

confidence: 99%

Gaseous nitric oxide for the local treatment of bacterial keratitis in mice

Deichelbohrer

Seitz

et al. 2016

Biomedical Reports

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Abstract. The successful treatment of severe bacterial keratitis continues to be a challenge in animals and humans. In the present study the aim was to assess gaseous therapy using gaseous nitric oxide (gNO) in a murine model of Pseudomonas aeruginosa keratitis. The cornea of anesthetized mice was mechanically scratched and covered with a bacterial suspension of P. aeruginosa. One day later, the infected eyes were exposed to 200 ppm NO for 30 min. Three to seven days later the mice were sacrificed and the bulbi were obtained and processed for light microscopy. The read out parameter was the maximal corneal thickness and the severity of the hypopyon. The therapy with NO did not result in either a reduction of inflammation concerning the maximal corneal thickness or the severity of the hypopyon. The bacterial load was not investigated due to technical limitations. Thus, exposure to gNO did not reduce the local inflammation in P. aeruginosa induced murine keratitis at the investigated time-points. This does not exclude effects of NO on the bacterial load, and in experimental and human keratitis. IntroductionBacterial keratitis is a major cause of blindness worldwide with a high incidence (1). This is due to low hygiene standards and water quality with a greater risk of infection in poor countries. In addition, the widespread use of contact lenses and associated complications in wealthier countries contributes to severe keratitis (2,3). Staphylococcus aureus and Pseudomonas aeruginosa are two predominant gram-positive and gram-negative bacterial strains responsible for causing this disease (1,4,5). The resistance of bacteria to antibiotics is reducing the efficacy of bacterial keratitis treatment. Therefore, research into the development of novel therapeutic approaches is essential. In this regard photodynamic inactivation has been in experimental and clinical use throughout the last decade (6-8). Research on cystic fibrosis established an antimicrobial effect of gaseous nitric oxide (gNO) in infections with P. aeruginosa using a rat model (9). Furthermore, a study in white rabbits demonstrated that a treatment using 200 ppm gNO significantly reduced the bacterial load in wounds of the dorsal skin surface (10). Thus, in view of the possibility of a surface treatment for keratitis, this therapeutic strategy demonstrated a feasible approach.The aim of the current study was to evaluate gNO application as a potential treatment of experimental keratitis in vivo for the first time. However, this series of experiments did not serve as proof of the anti-inflammatory effect of gNO. Materials and methodsAnimals and anaesthesia. Young (age, 9-10.5 weeks) female C57BL/6 mice [n=19; standard housing conditions (3-5 animals per cage) with 12-h light/dark cycle, minimum 70% humidity and chow/water were provided ad libitum; Janvier Labs, Saint-Berthevin Cedex, France] were used in the present study. All animal care and experimental procedures were approved by the local governmental animal care committee (permit no. 58/2013) and wer...

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