April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Forward-Looking and Multicentric Study of Ocular Pharmacokinetics of Riboflavin in Vivo During a Procedure of Corneal Collagen Cross-Linking : 25 Cases Report
Author Affiliations & Notes
  • Antoine Viennet
    CHU CLERMONT FERRAND, Clermont-Ferrand, France
  • Francois J. Malecaze
    Ophthalmology/U563, INSERM/Purpan Hospital, Toulouse, France
  • Joaquim Murta
    University Hospital Coimbra, Coimbra, Portugal
  • Pierre Fournie
    CHU PURPAN TOULOUSE, Toulouse, France
  • Audrey Borel
    CHU CLERMONT FERRAND, Clermont-Ferrand, France
  • Estelle Daniel
    CHU CLERMONT FERRAND, Clermont-Ferrand, France
  • Nathalie Monneyron
    CHU CLERMONT FERRAND, Clermont-Ferrand, France
  • Louise Marie Coulangeon
    CHU CLERMONT FERRAND, Clermont-Ferrand, France
  • José Cunha-Vaz
    University Hospital Coimbra, Coimbra, Portugal
  • Frederic Chiambaretta
    CHU CLERMONT FERRAND, Clermont-Ferrand, France
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 5201. doi:
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      Antoine Viennet, Francois J. Malecaze, Joaquim Murta, Pierre Fournie, Audrey Borel, Estelle Daniel, Nathalie Monneyron, Louise Marie Coulangeon, José Cunha-Vaz, Frederic Chiambaretta; Forward-Looking and Multicentric Study of Ocular Pharmacokinetics of Riboflavin in Vivo During a Procedure of Corneal Collagen Cross-Linking : 25 Cases Report. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5201.

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Abstract

Purpose: : Corneal collagen cross linking in evolutive keratoconus is a photochemical reaction which catalyzes a biochemical reaction. For the first time, we offer its study and we bring it to light by measuring riboflavin fluorescence in vivo through a 25 procedures serie carried out in Clermont-Ferrand University Hospital Center and Toulouse University Hospital Center.

Methods: : We present a 25 patients serie treated with collagen cross linking coupled with fluorescence analysis. This test is carried out with master FM-2 Fluorotron, usually used for flurescein study. We calculated the correction factor to adjust our device to the riboflavin study. Thus we have been able through this procedure to study the ocular pharmacokinetics of riboflavin (Ricrolin®).

Results: : The study of corneal fluorescence variation in anterior chamber and lens before, while and after the procedure allows us to confirm each step of the chain reaction for the first time in an in vivo study. Then we can detect the corneal impregnation of riboflavin ( with concentration measurement in ng/mL) and its intracameral path. Moreover, we can show the riboflavin screen effect on UVA and its reduction under UVA . Finally, the hypothesis of links created between collagen strands, then unverified in vivo, can be emphasized through our study.

Conclusions: : As the first study of riboflavin pharmacokinetics in vivo during corneal collagen cross linking, this study can confirm theoretical hypotheses and objectify the treatment efficiency in the same way. Fluorescence study allows to measure low concentration with excellent reliability. Collagen cross linking coupled with fluorometry could help to estimate cross linking immediate efficiency and to change its practice.

Keywords: keratoconus • cornea: storage • microscopy: light/fluorescence/immunohistochemistry 
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