Purchase this article with an account.
C. R. Brandt, S. E. Altmann, A. Emanuel, M. Toomey, K. B. McIntyre, J. Covert, R. R. Dubielzig, G. L. Leatherberry, C. J. Murphy, S. Kodihalli; Therapeutic Interventions for Vaccinia Virus Keratitis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3885.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
C. R. Brandt1,,3,4,5 , S. Altmann1, A. Emanuel2, M.Toomey3, K. McIntyre5, J. Covert5, R. Dubielzig5, G. Leatherberry4, C. J. Murphy4,5 , and S. Kodihalli2.Departments of Medical Microbiology & Immunology1, Ophthalmology & Visual Sciences3, and Surgical Sciences4, University of Wisconsin-Madison; Comparative Ophthalmic Research Laboratories, University of Wisconsin-Madison5; Pre-clinical Research, Cangene Corporation, Winnipeg, Manitoba, Canada2
Vaccinia virus keratitis (VACVK) is a severe complication of smallpox vaccination that can result in blindness. There are no FDA-approved treatments for VACVK and vaccinia immunoglobulin (VIG) is contra-indicated for use against isolated VACVK, but approved for use in aberrant infections induced by vaccinia virus, including accidental implantation in the eye. Other therapies have been used but a comprehensive comparison of the effectiveness of the different treatments in any animal model has not been done. The goals of this work were to determine if VIG exacerbates corneal scarring during VACVK and to compare the efficacies of several combinations of therapies for VACVK.
Trephined eyes of female rabbits were infected with 105 pfu of the Dryvax strain of Vaccinia virus and scored daily for disease for 28 days using a modified MacDonald-Shadduck scoring system. Animals were treated for 10 days after the onset of keratitis with albumin, VIG, prednisolone acetate, Viroptic, or combinations thereof.Ocular viral titers and vaccinia-specific antibody titers were determined by plaque assay and ELISA.
Treatment with VIG had no effect on the severity of VACVK. The inclusion of prednisolone acetate interfered with viral clearance resulting in a rebound of keratitis. The most effective treatment for VACVK was Viroptic alone. Viral titers were lower only in groups receiving Viroptic. Anti-VACVC antibody titers were similar in all groups on days 14 and 28.
We conclude that 1) VIG should be considered clinically to treat non-ocular adverse reactions to vaccination even when corneal involvement is present, 2) topical steroids should not be used for VACVK, and 3) treatment with viroptic TFT with or without intravenous VIG is the preferred therapeutic regimen for treating VACVK, and 4) VIG treatment does not interfere with the development of an antibody response following ocular infection.Disclosures: No commercial interest CRB, SEA, MT, KM, JC, RD, GL, and CJM. Cangene Corp. AE and SK
This PDF is available to Subscribers Only