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Riboflavin and Ultraviolet A Collagen Crosslinking of the Cornea for the Treatment of Keratitis.

Morén, Håkan LU ; Malmsjö, Malin LU ; Mortensen, Jes and Ohrström, Arne (2010) In Cornea 29. p.102-104
Abstract
PURPOSE:: To describe riboflavin and ultraviolet light (UV) collagen crosslinking as an effective treatment for infectious keratitis. METHODS:: A 25-year-old previously healthy female contact lens user was diagnosed with unilateral severe keratitis with unclear pathogenesis, although the clinical presentation suggested acanthamoeba as the infectious agent. A 4-mm diameter, annular, semi-opaque infiltrate was found on the paracentral parts of the cornea in the left eye (OS). Laboratory examinations for bacteria, herpes simplex, and acanthamoeba were performed, but no specific pathogen could be detected. Best corrected visual acuity (BCVA) at presentation was 20/1000. Treatment was initialized with broad-spectrum antibiotics also covering... (More)
PURPOSE:: To describe riboflavin and ultraviolet light (UV) collagen crosslinking as an effective treatment for infectious keratitis. METHODS:: A 25-year-old previously healthy female contact lens user was diagnosed with unilateral severe keratitis with unclear pathogenesis, although the clinical presentation suggested acanthamoeba as the infectious agent. A 4-mm diameter, annular, semi-opaque infiltrate was found on the paracentral parts of the cornea in the left eye (OS). Laboratory examinations for bacteria, herpes simplex, and acanthamoeba were performed, but no specific pathogen could be detected. Best corrected visual acuity (BCVA) at presentation was 20/1000. Treatment was initialized with broad-spectrum antibiotics also covering acanthamoeba. During the first month of treatment the keratitis progressed and the corneal thickness diminished. Therefore, treatment with riboflavin and UV collagen crosslinking was initiated. RESULTS:: After riboflavin and UV collagen crosslinking therapy, there was a rapid decrease of pain and necrotic material. Reepithelialization of the cornea started within a few days and was complete within a month. After 2 months, the wound had healed completely. Nine months after the UV treatment, BCVA was 20/30. CONCLUSIONS:: This case illustrates the positive effects of riboflavin and UV collagen crosslinking on presumed infectious keratitis with a satisfactory final visual outcome. This may be a promising new treatment for keratitis, although this remains to be elucidated in detail in future studies. Until more data are available this treatment should only be considered in therapy-refractive keratitis or ulceration and not in the first line of defence since it may have cytotoxic side effects. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Cornea
volume
29
pages
102 - 104
publisher
Lippincott Williams and Wilkins
external identifiers
  • wos:000273211500018
  • pmid:19730094
  • scopus:75649085347
ISSN
1536-4798
DOI
10.1097/ICO.0b013e31819c4e43
language
English
LU publication?
yes
id
027c5746-f352-4732-8afe-444a0304db07 (old id 1483811)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19730094?dopt=Abstract
date added to LUP
2009-10-05 15:50:09
date last changed
2018-06-10 04:48:50
@article{027c5746-f352-4732-8afe-444a0304db07,
  abstract     = {PURPOSE:: To describe riboflavin and ultraviolet light (UV) collagen crosslinking as an effective treatment for infectious keratitis. METHODS:: A 25-year-old previously healthy female contact lens user was diagnosed with unilateral severe keratitis with unclear pathogenesis, although the clinical presentation suggested acanthamoeba as the infectious agent. A 4-mm diameter, annular, semi-opaque infiltrate was found on the paracentral parts of the cornea in the left eye (OS). Laboratory examinations for bacteria, herpes simplex, and acanthamoeba were performed, but no specific pathogen could be detected. Best corrected visual acuity (BCVA) at presentation was 20/1000. Treatment was initialized with broad-spectrum antibiotics also covering acanthamoeba. During the first month of treatment the keratitis progressed and the corneal thickness diminished. Therefore, treatment with riboflavin and UV collagen crosslinking was initiated. RESULTS:: After riboflavin and UV collagen crosslinking therapy, there was a rapid decrease of pain and necrotic material. Reepithelialization of the cornea started within a few days and was complete within a month. After 2 months, the wound had healed completely. Nine months after the UV treatment, BCVA was 20/30. CONCLUSIONS:: This case illustrates the positive effects of riboflavin and UV collagen crosslinking on presumed infectious keratitis with a satisfactory final visual outcome. This may be a promising new treatment for keratitis, although this remains to be elucidated in detail in future studies. Until more data are available this treatment should only be considered in therapy-refractive keratitis or ulceration and not in the first line of defence since it may have cytotoxic side effects.},
  author       = {Morén, Håkan and Malmsjö, Malin and Mortensen, Jes and Ohrström, Arne},
  issn         = {1536-4798},
  language     = {eng},
  pages        = {102--104},
  publisher    = {Lippincott Williams and Wilkins},
  series       = {Cornea},
  title        = {Riboflavin and Ultraviolet A Collagen Crosslinking of the Cornea for the Treatment of Keratitis.},
  url          = {http://dx.doi.org/10.1097/ICO.0b013e31819c4e43},
  volume       = {29},
  year         = {2010},
}