Zhao Zhennan, Chen Xueli, Shao Yi, Shao Tingting
Eye Institute and Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China.
NHC Key Laboratory of Myopia Fudan University, Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
Front Med (Lausanne). 2022 Jun 28;9:869429. doi: 10.3389/fmed.2022.869429. eCollection 2022.
To compare the antifungal efficacy of corneal cross-linking (CXL) and voriconazole in experimental keratitis models.
Thirty-nine New Zealand rabbits were divided into three groups: a control group, a voriconazole group (M group), and a voriconazole combined with CXL group (CXL-M group). The ulcer area was measured via slit lamp imaging, the corneal and corneal epithelial thickness, and ulcer depth was measured via anterior segment optical coherence tomography (AS-OCT). The existence time of the hyphae was observed via confocal microscopy (IVCM), and the cornea was taken for pathological examination after modeling and at the end of the study to determine the hyphae and corneal repair. The observation times were as follows: at successful modeling and at 1, 4, 7, 14, 21, and 28 days after intervention.
In the CXL-M group, ulcer area and depth decreased continuously from Day 4 to Day 28 after CXL (all < 0.05). In the CXL-M group, ulcer area and depth were smaller than those in the other two groups from Day 4 to Day 21 after CXL (all < 0.05, except ulcer area in the CXL-M vs. M group on Day 21). The duration of hyphae in the CXL-M group was significantly shorter than in the other two groups ( = 0.025). On Day 28, in CXL-M group, corneal thickness was thicker than baseline ( < 0.05). Meanwhile, in CXL-M group, corneal and corneal epithelial thickness were significantly thinner than in the other two groups ( < 0.001). The CXL-M group had no complications, such as corneal perforation, at the end of the study.
Voriconazole combined with CXL is effective in treating -infected keratitis. Combined therapy could effectively inhibit , accelerate corneal repair, and shorten the course of the disease.
比较角膜交联术（CXL）和伏立康唑在实验性角膜炎模型中的抗真菌疗效。
将39只新西兰兔分为三组：对照组、伏立康唑组（M组）和伏立康唑联合角膜交联术组（CXL-M组）。通过裂隙灯成像测量溃疡面积，通过眼前节光学相干断层扫描（AS-OCT）测量角膜厚度、角膜上皮厚度和溃疡深度。通过共聚焦显微镜（IVCM）观察菌丝的存在时间，并在建模后和研究结束时取角膜进行病理检查，以确定菌丝和角膜修复情况。观察时间如下：成功建模时以及干预后1、4、7、14、21和28天。
在CXL-M组中，角膜交联术后第4天至第28天溃疡面积和深度持续下降（均P<0.05）。在CXL-M组中，角膜交联术后第4天至第21天溃疡面积和深度小于其他两组（均P<0.05，第21天CXL-M组与M组的溃疡面积比较除外）。CXL-M组菌丝持续时间明显短于其他两组（P = 0.025）。在第28天，CXL-M组角膜厚度比基线增厚（P<0.05）。同时，CXL-M组角膜厚度和角膜上皮厚度明显薄于其他两组（P<0.001）。研究结束时，CXL-M组无角膜穿孔等并发症。
伏立康唑联合角膜交联术治疗真菌感染性角膜炎有效。联合治疗可有效抑制真菌，加速角膜修复，缩短病程。
