Ocular Microbiology and Immunology Group
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2018 OMIG Abstract

Rose Bengal Photodynamic Antimicrobial Therapy (RB-PDAT) as Adjunct Treatment for Infectious Keratitis

Jaime D. Martinez, MD^1,2, Andrea Naranjo, MD^1,2, Alejandro Arboleda, MS¹, Heather Durkee, MS¹,
Mariela C. Aguilar, MS¹, Nidhi Relhan, MD^1,2, Neda Nikpoor, MD¹, Harry W. Flynn Jr, MD¹, Darlene Miller, DHSc², Guillermo Amescua, MD^1,2, Jean-Marie Parel, PhD^1,2
1Anne Bates Leach Eye Hospital and ²Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL

Methods: Retrospective chart review of all patients, older than 12 years-old, with a diagnosis of progressive infectious keratitis unresponsive to standard medical therapy who underwent Rose Bengal photodynamic antimicrobial therapy at the Bascom Palmer Eye Institute from January 2016 through March 2018. Data regarding age, sex, medical history, ophthalmic evaluation, diagnosis, surgeries performed as well as imaging and histopathology findings were collected. Rose Bengal PDAT was performed by applying a solution of Rose Bengal (0.1% or 0.2% RB in BSS) to the de-epithelized cornea for 30 minutes followed by irradiation with a 6mW/cm2 custom-made green LED source (525nm) for 15 minutes (5.4J/cm2).

Results: A total of 20 eyes were treated in 19 patients, 42% males and 60% females. The average age of patients at treatment was 47 years (range 17-83 years). Fifty percent (10/20) of cases had confirmed Acanthamoeba keratitis, Fusarium was identified in 20% (4/20), 10% (2/10) had Curvularia, and 10% (2/10) Pseudomonas aeruginosa. Two patients had no confirmed microbiologic diagnosis. Contact lens use (58%) was identified as the major risk factor. The average area of epithelial defect at presentation was 31.9 26.9mm2 and average depth of infection measured with anterior segment OCT was 277 78.5 m. Successful PDAT (defined as avoidance of therapeutic keratoplasty) was achieved in 75% of the cases, with an average time to clinical resolution of 48 25.5 days after Rose Bengal PDAT. BCVA improved -1.84 0.91 LogMAR (p<0.01) from presentation to final follow up.

Conclusion: Our results demonstrate the beneficial effect of Rose Bengal PDAT as adjunct therapy for infectious keratitis. Rose Bengal PDAT can be considered in severe resistant infectious keratitis before performing a therapeutic penetrating keratoplasty. This treatment could reduce the time to clinical resolution, minimize corneal melting, prevent perforation, and/or recurrence of the infection.

Disclosure: N

Support: Edward D. and Janet K. Robson Foundation, Florida Lions Eye Bank and the Beauty of Sight Foundation, Drs. KR Olsen, ME Hildebrant, Raksha Urs and Aaron Furtado; NIH Center Grant P30EY14801, Research to Prevent Blindness, Henri and Flore Lesieur Foundation (JMP).

2018 Agenda and Abstracts | < Previous Next >