Rose Bengal PDAT a promising adjunct therapy for infectious keratitis

In patients with infectious keratitis, Rose Bengal (RB) photodynamic antimicrobial therapy (PDAT) mitigates the need for therapeutic penetrating keratoplasty, as shown in a recent study. However, keratoplasty after RB-PDAT may increase the chances of graft survival at 1 year postoperatively.

Researchers reviewed the medical records of 31 eyes from 30 consecutive individuals with infectious keratitis refractory to standard medical therapy who underwent RB-PDAT. They drew data on demographics, risk factors for infectious keratitis, microbiological diagnosis, Best Spectacle-Corrected Visual Acuity (BCVA), clinical outcomes after RB-PDAT, and complication rates postkeratoplasty.

The population has a mean age of 53 years, and 70 percent of them were female, while 53.3 percent self-identified as non-Hispanic White and 43.3 percent Hispanic. The mean follow-up time was 28.0 months.

Factors associated with increased risk of infectious keratitis included contact lens use (80.6 percent), history of infectious keratitis (19.3 percent), and ocular surface disease (16.1 percent). Cultures from the patient samples were positive for Acanthamoeba (51.6 percent), Fusarium (12.9 percent), and Pseudomonas (6.5 percent). Some 22.5 percent of patients with Acanthamoeba infection were treated with concomitant miltefosine.

A total of 77.4 percent of patients achieved clinical resolution about 2.72 months after RB-PDAT, with 22.5 percent requiring therapeutic penetrating keratoplasties and 54.8 percent subsequently requiring optical penetrating keratoplasties. At 2 years, the overall probability of graft survival was 78.7 percent, and the graft failure rate was 21.3 percent.