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. 2020 Dec:8:245-251.
doi: 10.1007/s40135-020-00252-y. Epub 2020 Sep 12.

Photodynamic Therapy for Infectious Keratitis

Diego Altamirano  1 , Jaime Martinez  1 , Katherine D Leviste  2 , Jean Marie Parel  1   3 , Guillermo Amescua  1
Affiliations

Photodynamic Therapy for Infectious Keratitis

Diego Altamirano et al. Curr Ophthalmol Rep. 2020 Dec.

Abstract

Infectious keratitis is a sight-threatening microbial infection. The prevalence of antimicrobial resistance in cases of infectious keratitis has increased the demand for fortified compounded antimicrobial drops. Even with proper medical management, severe cases of infectious keratitis can further evolve into corneal perforation, requiring surgical intervention in the form of keratoplasty to control the infectious process. Due to the invasive nature of the procedure and the shortage of available donor tissue around the world, alternative treatments are needed for the management of progressive infectious keratitis. In ophthalmology, photodynamic therapy (PDT) has been used for numerous applications. PDT with Rose Bengal as a photosensitizer combined with green light optical irradiation (RB-PDAT) is a novel treatment with dual purpose: to arrest the infection from progressing and strengthen the collagen of the cornea. RB-PDAT may be considered as an adjunct therapy in severe cases of infectious keratitis to minimize the need for a therapeutic keratoplasty.

Keywords: cornea; epithelial defect; infectious keratitis; ocular surface; rose bengal photodynamic antimicrobial therapy.

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Conflict of interest statement

Conflict of Interest Jean Marie Parel and Guillermo Amescua are authors of a University of Miami invention disclosure on the instrument described herein. Diego Altamirano, Jaime Martinez, and Katherine D Leviste each declare no potential conflicts of interest.

Figures

Figure 1.
Figure 1.
A case of a 68-year-old female patient, with a history of Ocular Cicatricial Pemphigoid and a confirmed diagnosis of bilateral Curvularia keratitis. (A, B) Clinical appearance at presentation with bilateral deep corneal infiltrates, paracentral melting, thinning and hypopyon. (C, D) RB-PDAT was performed due to lack of response to standard medical treatment. (E, F) Appearance of the ocular response to RB-PDAT procedure where corneal melt and thinning have stopped, a decreased in conjunctival inflammation with less infiltrate, and grossly significant improvement. The corneal epithelium has healed and steroid drops were started. (G, H) Patient with a bilateral clinical resolution of the infection.
See this image and copyright information in PMC

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