Document Detail


UVA-riboflavin photochemical therapy of bacterial keratitis: a pilot study.
MedLine Citation:
PMID:  21874347     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this work as to investigate the photochemical interaction used in corneal crosslinking (CXL) as the primary therapy for bacterial keratitis.
METHODS: A prospective non-randomized study was conducted including 16 patients with a clinical diagnosis of bacterial keratitis. No patient had any prior antibiotic treatment for the current infection. Photography and microbial culturing of the infected cornea were performed. Riboflavin was topically administered for 20 min and ultraviolet light (UVA) exposure settings for treatment of keratoconus were used. After the procedure, clinical examinations were done at least once daily until signs of improvement had been established. The frequency of examinations was thereafter reduced. Antibiotic therapy was initiated if infectious progression was suspected. The trial was registered at ISCRTN.org (no: 21432643).
RESULTS: All eyes responded to the photochemical treatment with improvement in symptoms and signs of reduced inflammation. Epithelial healing was achieved in all cases. Antibiotic administration was necessary in two cases. One patient required a human amniotic membrane transplant.
CONCLUSIONS: This trial illustrates that photosensitization of riboflavin using UVA at 365 nm has the potential to induce healing in patients with microbial keratitis. The results from the treatment of these 16 patients with corneal ulcers indicate that UVA-riboflavin photochemical therapy merits a controlled study in order to assess its efficacy and safety compared to antibiotics.
Authors:
Karim Makdoumi; Jes Mortensen; Omid Sorkhabi; Bo-Eric Malmvall; Sven Crafoord
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2011-08-27
Journal Detail:
Title:  Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie     Volume:  250     ISSN:  1435-702X     ISO Abbreviation:  Graefes Arch. Clin. Exp. Ophthalmol.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-20     Completed Date:  2012-03-28     Revised Date:  2013-04-03    
Medline Journal Info:
Nlm Unique ID:  8205248     Medline TA:  Graefes Arch Clin Exp Ophthalmol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  95-102     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, Örebro University Hospital, 701 85 Örebro, Sweden. karim.makdoumi@orebroll.se
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MeSH Terms
Descriptor/Qualifier:
Administration, Topical
Adolescent
Adult
Aged
Aged, 80 and over
Bacteria / isolation & purification*
Conjunctiva / microbiology
Cornea / microbiology
Corneal Ulcer / drug therapy*,  microbiology
Eye Infections, Bacterial / drug therapy*,  microbiology
Female
Humans
Male
Middle Aged
Photochemotherapy*
Photosensitizing Agents / therapeutic use*
Prospective Studies
Riboflavin / therapeutic use*
Ultraviolet Rays*
Visual Acuity / physiology
Chemical
Reg. No./Substance:
0/Photosensitizing Agents; 83-88-5/Riboflavin
Comments/Corrections
Comment In:
Graefes Arch Clin Exp Ophthalmol. 2013 Mar;251(3):997-8   [PMID:  22349981 ]
Graefes Arch Clin Exp Ophthalmol. 2013 Mar;251(3):995-6   [PMID:  22331148 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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