Clinical Outcomes of Rose Bengal Mediated Photodynamic Antimicrobial Therapy on Fungal Keratitis with Their Microbiological and Pathological Correlation

Bagga, Bhupesh; Sharma, Savitri; Ahirwar, Lalit Kishore; Sheba, Esther; Vaddavalli, Pravin K.; Mishra, Dilip Kumar

doi:10.1080/02713683.2022.2058019

Cited by 7 publications

(1 citation statement)

References 29 publications

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“…40 In the first prospective study evaluating rose bengal PDAT as an early treatment, all 3 patients diagnosed with Fusarium keratitis resolved, while 3 patients with Aspergillus and 1 patient with Acremonium infections worsened and required therapeutic penetrating keratoplasty. 41 Rose bengal PDAT is the subject of the Rose Bengal Electromagnetic Activation with Green Light for Infection Reduction trial, which was enrolling patients at the time of this article preparation.…”

Section: Managementmentioning

confidence: 99%

Overview of Mycotic Keratitis

Arboleda,

2024

Cornea

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Keratomycosis is a serious corneal infection associated with high ocular morbidity that can lead to severe vision loss. It is estimated to affect more than 1 million patients annually, most commonly occurring in tropical climates, and represents a growing threat to patients worldwide. Despite aggressive medical management, fungal infections have a higher rate of perforation requiring surgical intervention compared with other infectious etiologies. Early diagnosis and appropriate treatment are keys to preserving vision and saving patients' eyes. Timely diagnosis of fungal keratitis helps minimize corneal damage and scarring and increases the likelihood of a favorable outcome. Studies have shown that correct identification of fungal infections is often delayed up to 2 to 3 weeks after initial presentation. This leads to incorrect or ineffective treatment for many patients. Diagnostic techniques explored in this study include corneal scrapings with staining and culture, visualization with in vivo confocal microscopy, molecular diagnostic techniques including polymerase chain reaction, and recently developed omics-based technologies. Treatment of fungal keratitis begins with topical antifungals. Medical management has been proven to be effective, but with limitations including poor drug penetration and low bioavailability. Cases that do not respond to topical therapy require more invasive and novel treatments to control the infection. We review the clinical trials that have shaped current practice patterns, with focus on the efficacy of topical natamycin as the primary therapy for filamentous fungal keratitis. We explore additional management strategies such as localized intrastromal and intracameral injections of antifungal medications, photodynamic therapy, and surgical intervention.

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Section: Managementmentioning

confidence: 99%