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Effect of voriconazole and ultraviolet - A combination therapy compared to voriconazole single treatment on fusarium solani fungal keratitis

Authors
 Choi Kyoung Sub  ;  Yoon Sang Chul  ;  Rim Tyler Hyung Taek  ;  Han Soo Jung  ;  Kim Eun-Do  ;  Seo Kyoung Yul 
Citation
 JOURNAL OF OCULAR PHARMACOLOGY AND THERAPEUTICS, Vol.30(5) : 381-386, 2014 
Journal Title
 JOURNAL OF OCULAR PHARMACOLOGY AND THERAPEUTICS 
ISSN
 1080-7683 
Issue Date
2014
MeSH
Animals ; Antifungal Agents/administration & dosage ; Combined Modality Therapy/methods ; Eye Infections, Fungal/pathology ; Eye Infections, Fungal/therapy* ; Fusariosis/pathology ; Fusariosis/therapy* ; Fusarium/drug effects ; Fusarium/isolation & purification* ; Fusarium/radiation effects ; Humans ; Keratitis/pathology ; Keratitis/therapy* ; Rabbits ; Treatment Outcome ; Ultraviolet Therapy/methods* ; Voriconazole/administration & dosage*
Abstract
Purpose: To demonstrate that ultraviolet-A (UV-A) and voriconazole combination therapy is more effective than voriconazole single treatment for fungal keratitis. Methods: The in vitro UV-A (375 nm) fungicidal effect was evaluated on Fusarium solani solutions. Each fungal solution was irradiated with different UV-A irradiation doses. Also, a fungal solution containing voriconazole was also irradiated with UV-A. The in vivo therapeutic effect of UV-A and voriconazole treatment was studied in a rabbit keratitis model. Fungi were injected intrastromally into the cornea of 16 rabbits. Each treatment was initiated 3 days after fungal injection and continued up to 8 days for the following groups: Group 1, control; Group 2, treated with UV-A once a day; Group 3, treated with voriconazole 3 times a day; Group 4, treated with voriconazole 3 times a day and UV-A once a day. On the last day, the sclera–cornea buttons were extracted and microbiological and histological evaluations were performed. Results: The colony-forming units (CFUs) of fungal solutions in culture significantly decreased with UV-A irradiation. The CFUs of fungal solutions containing voriconazole also decreased with UV-A irradiation. In vivo, clinical scores of Group 3 (P=0.03) and Group 4 (P=0.02) 5 days after treatment were significantly lower compared to that of Group 1. The clinical score of Group 4 (P=0.03) 5 days after treatment was significantly lower compared to that of Group 3. The histopathological scores 5 days after treatment were significantly lower in Group 4 compared to those of Group 1 (P<0.01) and Group 3 (P=0.02). Based on our CFU analysis, only Group 4 showed significantly lower CFUs compared to Group 1 (P=0.04). Conclusions: UV-A and voriconazole combination treatment could be a safe and effective alternative to voriconazole single treatment for fungal keratitis.
Full Text
http://online.liebertpub.com/doi/abs/10.1089/jop.2013.0167
DOI
10.1089/jop.2013.0167
Appears in Collections:
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eun Do(김은도)
Seo, Kyuong Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
Yoon, Sang Chul(윤상철) ORCID logo https://orcid.org/0000-0003-0454-9597
Rim, Tyler Hyungtaek(임형택)
Han, Soo Jung(한수정)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98969
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