|
|
Experimental Treatment of Acanthamoeba Keratitis in Rabbit Eyes by Drug and Iontophoretic Collagen Crosslinking |
Yali Zhang,Limei Liu,Yuqiang Liu,Shaobin 2hang,Chunxiu Ming,Lifeng Liu |
Weifang Medical University, Weifang 261061, China
Weifang Eye Institute, Weifang Eye Hospital, Weifang 261041, China |
|
|
Abstract Objective: To evaluate the efficacy of drug treatment and iontophoretic collagen crosslinking alone and in combination in the treatment for acanthamoeba keratitis in rabbits. Methods: Rabbit corneas were scraped with circular blades and 0.1 ml acanthamoeba suspension was injected into the central corneal stroma. The injection caused a-3.O-mm diameter white edematous area. A soft corneal contact lens was then applied. Forty-eight hours after acanthamoeba were injected into the comeal stroma, the rabbits were randomly divided into four groups: Group A, untreated (n=10). Group B, treated 7 times/day with eyedrops containing 0.02% chlorhexidine combined with 2% metronidazole (n=10). Group C, stromal crosslinking with 0.1% riboflavin penetration by 5 min of iontophoresis, followed with 370 nm ultraviolet irradiation(10 mW/cm2, 9-mm aperture diameter, 9 min, total energy 5.4 J) (n=10). Group D, drug+crosslinked treatment (n=10). The right eye was selected as the experimental eye, and the left eye was the control eye.After treatment for 90 days, slit-lamp microscopy, confocal microscopy, and corneal histopathology were performed. Confocal microscopy was used to select the images with lesion depths of 100, 200, and 300 lim.The density of the acanthamoeba in each image was measured by Image J software. The experimental data were analyzed by Kruskal-Wallis H tests and 2x2 analysis of variance analysis. Results: After treatment for
90 days, the number of comeal lesions was significantly different in four groups (X2=19.73 8, P<O.O01). The classification of corneal lesions in the Groups B and C was significantly lower than that in the Group A, and the difference was statistically signmcant (P<0.05). The large reduction in the number of corneal lesions in Group D showed that the drug treatment and crosslinking acted synergistically to control the infection.Confocal microscopy measurements of the acanthamoeba density were significantly lower in the Groups B, C and D compared with the Group A (P<0.05). The combination of drug and crosslinking treatment synergistically lowered the density of the parasites. Histopathological sections stained by hematoxylin and
eosin confirmed the reduced density of acanthamoeba in the three treated groups compared to the Group A (P<0.05). The combination of drug and crosslinking treatment synergistically lowered the density of the parasites. Conclusions: Iontophoretic comeal collagen crosslinking of acanthamoeba keratitis in rabbit eyes is effective. The combination of drug therapy and crosslinking is superior to local drug therapy alone or simple crosslinking alone.
|
Received: 27 May 2017
|
Corresponding Authors:
Shaobin Zhang, Weifang Eye Institute, Weifang Eye Hospital, Weifang 261041,China (Email: zhangsb518@163.com)
|
|
|
|
[l] |
Szentmary N, Daas L. Matoula P, et al. Acanthamoeba keratitis.Ophthalmologe, 2013, 110(12): 1203-1210. DOI:10.1007/s00347-013-2981-0.
|
[2] |
畅颖,千森,姜超,等,反复发作的阿米巴性角膜炎一例.中华眼视光学与视觉科学杂志,2014,16(9): 564-565. DOl: 10.3760/cma:j .issn.1674-845X.2014.09.012.
|
[3] |
Spoerl E. Wollensak G. Seiler T.lncreased resistance of crosslinked cornea against enzymatic digestion. Curr Eye Res,2004, 29(1): 35-40. DOI: 10.1080/02713680490513182.
|
[2] |
畅颖,千森,姜超,等,反复发作的阿米巴性角膜炎一例.中华眼视光学与视觉科学杂志,2014,16(9): 564-565. DOl: 10.3760/cma:j .issn.1674-845X.2014.09.012.
|
[3] |
Spoerl E. Wollensak G. Seiler T.lncreased resistance of crosslinked cornea against enzymatic digestion. Curr Eye Res,2004, 29(1): 35-40. DOI: 10.1080/02713680490513182.
|
[4] |
刘家英,任辉.棘阿米巴人体致病菌的分离、培养和保存.寄生虫与医学昆虫学报,1988,5(2):88-91.
|
[4] |
刘家英,任辉.棘阿米巴人体致病菌的分离、培养和保存.寄生虫与医学昆虫学报,1988,5(2):88-91.
|
[5] |
朱学军,林秀丽,胡建章,等.角膜表面镜片术建立兔棘阿米巴角膜炎模型,眼科新进展,2010,30(5):418-421.
|
[5] |
朱学军,林秀丽,胡建章,等.角膜表面镜片术建立兔棘阿米巴角膜炎模型,眼科新进展,2010,30(5):418-421.
|
[6] |
McNeill JI. Kaufman HE. Local antivirals in a herpes simplex stromal keratitis model. Arch Ophthalrnol.1979,97(4):727-729.
|
[7] |
Muller Ll.Thiel MA, Kipfer-Kauer AI. et al. Corneal cross-linking as supplementary treatment option in melting keratitis:a case series. Klin Monbl Augenheilkd, 2012, 229(4): 411-415.DOI:10.1055/s-0031-1299420. Epub 2012 Apr 11.
|
[8] |
Clarke DW. Alizadeh H. Niederkorn JY. Failure of Acanthamoeba castellanii to produce intraocular infections. Invest Ophthalmol Vis Sci,2005.46(7): 2472-2478. DOI:10.1167/iovs.05-0140.
|
[9] |
Ammermann C, Cursiefen C. Hermann M. Corneal cross-linking in microbial keratitis to prevent a chaud keratoplasty: a retrospective case series. Klin Monbl Augenheilkd, 2014, 231(6): 619-625. DOI:10.1055/s-0034-1368535.
|
[10] |
Kocak I, Aydin A, Kaya F, et al. Comparison of transepithelial corneal collagen crosslinking with epithelium-off crosslinking in progressive keratoconus. J Fr Ophtalmol,2014,37(5):371-376.DOI:10.1016/j.j fo.2013.11.012.
|
[11] |
Skaat A, Zadok D, Goldich Y, et al. Riboflavin/UVA photochemical therapy for severe infectious keratitis. Eur J Ophthalmol.2014.24(1):21-28.DOI:10.5301/ejo.5000330.
|
[6] |
McNeill JI. Kaufman HE. Local antivirals in a herpes simplex stromal keratitis model. Arch Ophthalrnol.1979,97(4):727-729.
|
[7] |
Muller Ll.Thiel MA, Kipfer-Kauer AI. et al. Corneal cross-linking as supplementary treatment option in melting keratitis:a case series. Klin Monbl Augenheilkd, 2012, 229(4): 411-415.DOI:10.1055/s-0031-1299420. Epub 2012 Apr 11.
|
[8] |
Clarke DW. Alizadeh H. Niederkorn JY. Failure of Acanthamoeba castellanii to produce intraocular infections. Invest Ophthalmol Vis Sci,2005.46(7): 2472-2478. DOI:10.1167/iovs.05-0140.
|
[9] |
Ammermann C, Cursiefen C. Hermann M. Corneal cross-linking in microbial keratitis to prevent a chaud keratoplasty: a retrospective case series. Klin Monbl Augenheilkd, 2014, 231(6): 619-625. DOI:10.1055/s-0034-1368535.
|
[10] |
Kocak I, Aydin A, Kaya F, et al. Comparison of transepithelial corneal collagen crosslinking with epithelium-off crosslinking in progressive keratoconus. J Fr Ophtalmol,2014,37(5):371-376.DOI:10.1016/j.j fo.2013.11.012.
|
[11] |
Skaat A, Zadok D, Goldich Y, et al. Riboflavin/UVA photochemical therapy for severe infectious keratitis. Eur J Ophthalmol.2014.24(1):21-28.DOI:10.5301/ejo.5000330.
|
[12] |
原越,张少斌,刘玉强,等. 离子导入角膜胶原交联术治疗兔眼金黄色葡萄球菌性角膜炎的实验研究.中华实验眼科杂志,2014, 32(7): 607-612.
|
[13] |
Sorkhabi R, Sedgipoor M, MahdavifardA. Collagen cross-linking for resistant corneal ulcer. Int Ophthalmol. 2013, 33(1): 61-66DOI: 10.1007/s10792-012-9633-2.
|
[14] |
Khan YA. Kashiwabuchi RT, Martins SA, et al. Riboflavin and ultraviolet light a therapy as an adjuvant treatment for medically refractive Acanthamoeba keratitis: report of 3 cases. Ophthalmolgy,2011, 118(2): 324-331. DOI: 10.1016/j.ophtha.2010.06.041.
|
[15] |
Papaioannou Ll, Mili#os M, Papathanassiou M. Corneal Collagen Cross-Linking for Infectious Keratitis: A Systematic Review and Meta-Analysis. Comea. 2016, 35(1): 62-71. DOI: 10.1097/ICO.0000000000000644.
|
[12] |
原越,张少斌,刘玉强,等. 离子导入角膜胶原交联术治疗兔眼金黄色葡萄球菌性角膜炎的实验研究.中华实验眼科杂志,2014, 32(7): 607-612.
|
[13] |
Sorkhabi R, Sedgipoor M, MahdavifardA. Collagen cross-linking for resistant corneal ulcer. Int Ophthalmol. 2013, 33(1): 61-66DOI: 10.1007/s10792-012-9633-2.
|
[14] |
Khan YA. Kashiwabuchi RT, Martins SA, et al. Riboflavin and ultraviolet light a therapy as an adjuvant treatment for medically refractive Acanthamoeba keratitis: report of 3 cases. Ophthalmolgy,2011, 118(2): 324-331. DOI: 10.1016/j.ophtha.2010.06.041.
|
[15] |
Papaioannou Ll, Mili#os M, Papathanassiou M. Corneal Collagen Cross-Linking for Infectious Keratitis: A Systematic Review and Meta-Analysis. Comea. 2016, 35(1): 62-71. DOI: 10.1097/ICO.0000000000000644.
|
[16] |
Berra M, Galperin G. Boscaro G, et al. Treatment of Acanthamoeba keratitis by comeal collagen cross-linking. Comea. 2013, 32(2):174-178. DOl:10.1097/lCO.Ob013e31825cea99.
|
[16] |
Berra M, Galperin G. Boscaro G, et al. Treatment of Acanthamoeba keratitis by comeal collagen cross-linking. Comea. 2013, 32(2):174-178. DOl:10.1097/lCO.Ob013e31825cea99.
|
[17] |
Brindley GS. The Bunsen-Roscoe law for the human eye at very short durations. J Physiol. 1952, 118( 1): 135-139.
|
[18] |
罗顺荣,吴护平,林志荣,等,高能量紫外光照射的角膜胶原交联术治疗进展期圆锥角膜的安伞性及远期疗效分析,中华眼科医学杂志(电子版),2016(6): 260-266.DOI: 10.3877/cam.j.jssn.2095-2007.2016.06.004.
|
[17] |
Brindley GS. The Bunsen-Roscoe law for the human eye at very short durations. J Physiol. 1952, 118( 1): 135-139.
|
[18] |
罗顺荣,吴护平,林志荣,等,高能量紫外光照射的角膜胶原交联术治疗进展期圆锥角膜的安伞性及远期疗效分析,中华眼科医学杂志(电子版),2016(6): 260-266.DOI: 10.3877/cam.j.jssn.2095-2007.2016.06.004.
|
|
|
|