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Efficacy of Photodynamic Anti‐Microbial Chemotherapy for Acanthamoeba Keratitis In Vivo
Author(s) -
Dwia Pertiwi Yunialthy,
Chikama Taiichiro,
Sueoka Kentaro,
Ko JiAe,
Kiuchi Yoshiaki,
Onodera Makoto,
Sakaguchi Takemasa
Publication year - 2021
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.23355
Subject(s) - acanthamoeba keratitis , acanthamoeba , keratitis , cornea , medicine , contact lens , in vivo , photodynamic therapy , histopathology , ophthalmology , pathology , surgery , microbiology and biotechnology , biology , chemistry , organic chemistry
Background and Objectives Acanthamoeba keratitis is a sight‐threatening infectious disease that is difficult to treat. The aim of this study was to evaluate TONS504 (cationic chlorin derivative photosensitizer)‐mediated photodynamic antimicrobial chemotherapy (PACT) in vivo as a potential treatment for Acanthamoeba keratitis. Study Design/Materials and Methods Acanthamoeba keratitis was induced by soft contact lenses incubated with 1 × 10 5 /ml Acanthamoeba castellanii , which were placed over debrided corneas with temporary tarsorrhaphy. Thirty‐eight male Japanese white rabbits were randomly divided into three groups (normal eye, no treatment, and treatment groups). TONS504 was administered as eye drops at 1 mg/ml, followed by light‐emitting diode irradiation after the establishment of keratitis at 7 days after infectious contact lens exposure. All animals were evaluated under a slit‐lamp microscope every 3 days for 6 days after the treatment. Clinical scores based on corneal epithelial defects detected by fluorescein staining, stromal opacity edema, and vascular infiltration into the cornea were determined. After 6 days, the eyes were enucleated for histopathological analysis. Results Clinical signs of infection in the treatment group were markedly reduced for up to 6 days after treatment. Histopathology showed a regular arrangement of stromal fibers and a small number of inflammatory cells in 58% of the corneas. However, 42% of corneas in the treatment group showed infiltrating neutrophils and irregular alignment of stromal collagen fibers. Conclusions Our TONS504‐PACT achieved complete recovery from keratitis in 58% of the rabbit models. Further studies are required to determine the conditions for the maximal effectiveness of our TONS504‐PACT for Acanthamoeba keratitis. Lasers Surg. Med. © 2020 Wiley Periodicals LLC