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Treatment of Fungal Keratitis From Fusarium Infection by Corneal Cross-Linking

Galperin, Gustavo MD*†; Berra, Martín MD*†; Tau, Julia MS*; Boscaro, Gabriela MS‡; Zarate, Jorge PhD*; Berra, Alejandro PhD*

doi: 10.1097/ICO.0b013e318221cec7
Basic Investigation

Purpose: To evaluate the efficacy of corneal cross-linking (CXL) (riboflavin–UV-A) as a simple therapy in Fusarium keratitis.

Methods: Twenty-four rabbits were systemically anesthetized, and the stromata of their right corneas were inoculated with Fusarium solani [105 colony-forming units (CFU) per milliliter]. Rabbits were divided into 2 groups: one was treated with CXL 72 hours after infection and the other did not receive any treatment (control). All eyes in both the groups were examined before (days 0 and 3) and after (day 7) CXL treatment. The eyes were enucleated, and corneal buttons were sent for microbiological and histological examinations.

Results: All animals developed Fusarium keratitis; there was no statistically significant difference between groups before treatment (day 0, P = 0.397 and day 3, P = 0.702). After CXL treatment, the difference in clinical scores on day 7 between groups was statistically significant (P = 0.00); the CXL group showed significant lower clinical score. The CXL group had 22.45 ± 5.09 CFU/g compared with 42.5 ± 3.12 CFU/g in the control group; this difference was statistically significant (P = 0.01). In the 3 buttons of the control group, similar amounts of Fusarium hyphae and inflammatory cells were observed. In 2 of the 3 buttons analyzed from the CXL group, fewer Fusarium hyphae, inflammatory cells, and nonspecific stromal changes were observed compared with the control group.

Conclusions: Treatment of fungal keratitis with CXL seems to be effective in decreasing the intensity and severity of infectious keratitis by F. solani. This therapy may be useful as a coadjuvant in the medical treatment of resistant infections.

From the *Laboratorio de Investigaciones Oculares, Buenos Aires, Argentina; †Hospital Pedro Lagleyze, Buenos Aires, Argentina; and ‡BioFundus, Buenos Aires, Argentina.

Received for publication July 13, 2010; revision received February 6, 2011; accepted April 25, 2011.

The authors state that they have no financial or conflicts of interest to disclose.

Reprints: Martín Berra, Laboratorio de Investigaciones Oculares, Departamento de Patología, Facultad de Medicina, Universidad de Buenos Aires, José E. Uriburu 950, entrepiso, 1114 Buenos Aires, Argentina (e-mail: martinberra81@hotmail.com).

© 2012 Lippincott Williams & Wilkins, Inc.