Evaluation of accelerated collagen cross-linking for the treatment of melting keratitis in ten cats

Vet Ophthalmol. 2015 Mar;18(2):95-104. doi: 10.1111/vop.12112. Epub 2013 Oct 14.

Abstract

Objectives: Melting keratitis is a serious condition presenting a high risk of permanent blindness and is caused by infectious or noninfectious factors. In humans, the clinical efficacy of collagen cross-linking (CXL) has been described in the treatment of refractory infectious keratitis by arresting keratomalacia. The aim of this study was to evaluate the efficacy of accelerated CXL for the treatment of melting keratitis in cats.

Animals studied: Ten cats were treated for unilateral melting keratitis by accelerated CXL.

Procedure: Corneas were irradiated by UVA (370 nm) at 30 mW/cm² irradiance for 3 min after soaking with 0.1% riboflavin in 20% dextran for 30 min (D1). Follow-up was conducted 3, 7, 14, and 30 days after treatment.

Results: Pain improvement was noted for all cases at D4 examination. Epithelial healing was observed at D8 for 9 of 10 cases and at D15 for 1 of 10 cases. Resolution of cellular infiltration was observed for all cases at D8 examination. The corneal vascularization was reduced for 9 of 10 cats by D31. At D31, all cases presented a variable degree of corneal fibrosis, but all eyes had visual function. No recurrent infection was observed.

Conclusion: Accelerated CXL appears to be a valuable option for the treatment of melting keratitis in cats. All the cases have reached a satisfactory outcome despite the individual differences in the conditions prior to the CXL treatment and the variable presence of infectious agents.

Keywords: accelerated cross-linking; cat; corneal melting; cross-linking; keratitis; optical coherence tomography.

Publication types

  • Clinical Study

MeSH terms

  • Animals
  • Cat Diseases / therapy*
  • Cats
  • Cornea / blood supply
  • Cornea / pathology
  • Cornea / radiation effects
  • Dextrans / administration & dosage
  • Dextrans / pharmacology*
  • Keratitis / pathology
  • Keratitis / therapy
  • Keratitis / veterinary*
  • Prospective Studies
  • Riboflavin / administration & dosage
  • Riboflavin / pharmacology*
  • Ultraviolet Therapy / veterinary*

Substances

  • Dextrans
  • Riboflavin