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Y. A. Khan, S. A. Martins, W. Camacho, J. Castro-Combs, P. Wittmann, R. Walther, J. Dick, A. Behrens; Riboflavin/UVA Combined Treatment in a Rabbit Staphylococcus Aureus Keratitis Model: A New Approach for Corneal Infections. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5535.
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To explore the efficacy of riboflavin-Ultraviolet Light A (UVA) combined treatment in the eradication of corneal infection using a New Zealand White rabbit model of experimental gram-positive bacterial keratitis (Staphylococcus aureus).
One thousand colony-forming units (CFU) of S. aureus were intrastromally injected into rabbit cornea. A total of 24 eyes were infected and then divided into 4 groups: (C) Control group, no treatment; (UVA), treatment with UVA exposure for 30 minutes; (UVA+B2) UVA exposure for 30 minutes + riboflavin (B2) 0.1% drops every 2 minutes for 30 minutes, and (UVA+B2’) UVA exposure for 30 minutes + previously photosensitized riboflavin (B2) 0.1% drops every 2 minutes for 30 minutes. The corneal infections were monitored with digital photography for 5 days, and the appearance was compared with a digital software. The rabbits were then sacrificed, and the corneal buttons were harvested and processed appropriately to calculate the number of colony forming units (CFU) per cornea.
An immediate response to the treatment was observed at just 24 h after exposure. The median number of CFU of recoverable bacteria for C (n=6), UVA (n=6), UVA+B2 (n=6), and UVA+B2’ was 307.5, 45, 10, and 9.5, respectively. CFU were significantly reduced with all treatments, compared to the control, but UVA+B2 and UVA+B2’ were the most effective treatments, with no statistical difference between them.
These results indicate that UVA combined with riboflavin 0.1% drops appears to be an effective therapy for S. aureus keratitis in the rabbit model. These results may be used as a reference for the future potential treatment of bacterial keratitis in human subjects.
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