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角膜交联术治疗真菌性角膜炎的疗效:在印度南部一家三级眼科医院角膜胶原交联术作为真菌性角膜炎辅助治疗的效果

Therapeutic Effect of Corneal Crosslinking on Fungal Keratitis: Efficacy of Corneal Collagen Crosslinking as an Adjuvant Therapy for Fungal Keratitis in a Tertiary Eye Hospital in South India.

作者信息

Jeyalatha Mani Vimalin, Parthasarathy Durgadevi, Padmanabhan Prema, Narayanan Niveditha, Lakshmipathy Meena, Pachayappan Saravana Kumar, Jayavel Padmapriya, Therese Kulandhai Lily, Rao Madhavan Hajib Narahari, Jambulingam Malathi

机构信息

L&T Microbiology Research Centre, Vision Research Foundation, Sankara Nethralaya, Chennai, India.

Department of Cornea and Refractive Surgery, Medical Research Foundation, Sankara Nethralaya, Chennai, India.

出版信息

Ocul Immunol Inflamm. 2021 Nov 17;29(7-8):1648-1655. doi: 10.1080/09273948.2020.1770296. Epub 2020 Jul 9.

Abstract

PURPOSE

To evaluate the efficacy of CXL in treating fungal keratitis as an adjuvant therapy.

METHODS

Detailed clinical examination microbiological investigation was performed. Twenty fungal keratitis patients were recruited and randomized into two groups: group 1 (n= 11, standard antifungal), group 2 (n=9, corneal collagen crosslinking with standard antifungal). Corneal scraping and tear samples collected were subjected to real-time PCR targeting ITS, TLR analysis and cytokine analysis.

RESULTS

The mean time for complete resolution of ulcer for group 2 was significantly shorter compared to group 1 and the final mean BCVA was better for group 2. Expression of IL-1β, IL-8, IFN-γ significantly decreased immediately post CXL in group 2 patients. Significant downregulation of TLR 6, TLR-3, TLR-4 was observed 3-days post CXL compared to group 1 patients.

CONCLUSION

Adjuvant effect of CXL was significant in treating fungal keratitis compared to standalone antifungal treatment.

摘要

目的

评估角膜交联术(CXL)作为辅助治疗手段在治疗真菌性角膜炎中的疗效。

方法

进行详细的临床检查和微生物学调查。招募了20例真菌性角膜炎患者并随机分为两组:第1组(n = 11,标准抗真菌治疗),第2组(n = 9,角膜交联术联合标准抗真菌治疗)。对采集的角膜刮片和泪液样本进行靶向ITS的实时PCR、TLR分析和细胞因子分析。

结果

与第1组相比,第2组溃疡完全愈合的平均时间显著缩短,且第2组最终的平均最佳矫正视力更好。第2组患者在角膜交联术后即刻,IL-1β、IL-8、IFN-γ的表达显著降低。与第1组患者相比,角膜交联术后3天观察到TLR 6、TLR-3、TLR-4显著下调。

结论

与单独的抗真菌治疗相比,角膜交联术在治疗真菌性角膜炎方面的辅助作用显著。

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