Riboflavin/UVA photochemical therapy for severe infectious keratitis

Eur J Ophthalmol. Jan-Feb 2014;24(1):21-8. doi: 10.5301/ejo.5000330. Epub 2013 Jul 17.

Abstract

Purpose: To describe the antibacterial activity of treatment with riboflavin and ultraviolet A light (UVA) in cases of severe infectious keratitis.

Methods: A retrospective analysis was performed of an interventional case series in which 6 eyes of 6 patients with severe infectious keratitis, all of whom were refractive to multidrug conventional therapy, were treated with riboflavin/UVA. The procedure was conducted according to the standardized protocol of corneal collagen crosslinking (CXL) for keratoconus. Best spectacle-corrected visual acuity and clinical outcomes were evaluated before and during the follow-up period.

Results: Five of the 6 patients showed rapid reduction in symptoms and decreased infiltrate size after riboflavin/UVA photochemical therapy. Signs of infection and inflammation mostly resolved within 1 to 2 weeks after the treatment. Despite this therapy, one patient continued to deteriorate, and penetrating keratoplasty was performed.

Conclusions: The adjunctive use of riboflavin/UVA photochemical therapy has a positive effect on refractory infectious keratitis. The treatment seems to be safe and effective and should be considered as part of the first-line therapy in severe cases of infectious keratitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Corneal Ulcer / diagnosis
  • Corneal Ulcer / drug therapy*
  • Corneal Ulcer / microbiology
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / drug therapy*
  • Eye Infections, Bacterial / microbiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous / diagnosis
  • Mycobacterium Infections, Nontuberculous / drug therapy
  • Mycobacterium Infections, Nontuberculous / microbiology
  • Mycobacterium chelonae / isolation & purification
  • Photochemotherapy*
  • Photosensitizing Agents / therapeutic use*
  • Pseudomonas Infections / diagnosis
  • Pseudomonas Infections / drug therapy
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / isolation & purification
  • Retrospective Studies
  • Riboflavin / therapeutic use*
  • Serratia Infections / drug therapy
  • Serratia Infections / microbiology
  • Serratia marcescens
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology
  • Staphylococcus epidermidis / isolation & purification
  • Ultraviolet Rays
  • Young Adult

Substances

  • Photosensitizing Agents
  • Riboflavin