Variations in Irradiation Energy and Rose Bengal Concentration for Photodynamic Antimicrobial Therapy of Fungal Keratitis Isolates

Overview

Journal Lasers Med Sci

Publisher Springer

Date 2024 Feb 21

PMID 38379056

Authors

Alejandro Arboleda

Heather Durkee

Darlene Miller

Mariela C Aguilar

Karam Alawa

Nidhi Relhan

Guillermo Amescua

Jean-Marie Parel

Affiliations

Soon will be listed here.

Abstract

The purpose is to assess the efficacy of rose bengal photodynamic antimicrobial therapy (PDAT) using different irradiation energy levels and photosensitizer concentrations for the inhibition of fungal keratitis isolates. Seven different fungi (Aspergillus fumigatus, Candida albicans, Curvularia lunata, Fusarium keratoplasticum, Fusarium solani, Paecilomyces variotii, and Pseudallescheria boydii) were isolated from patients with confirmed infectious keratitis. Experiments were performed in triplicate with suspensions of each fungus exposed to different PDAT parameters including a control, green light exposure of 5.4 J/cm, 2.7 J/cm (continuous and pulsed), and 1.8 J/cm and rose bengal concentrations of 0.1%, 0.05%, and 0.01%. Plates were photographed 72 h after experimentation, and analysis was performed to assess fungal growth inhibition. PDAT using 5.4 J/cm of irradiation and 0.1% rose bengal completely inhibited growth of five of the seven fungal species. Candida albicans and Fusarium keratoplasticum were the most susceptible organisms, with growth inhibited with the lowest fluence and minimum rose bengal concentration. Fusarium solani, Pseudallescheria boydii, and Paecilomyces variotii were inhibited by lower light exposures and photosensitizer concentrations. Aspergillus fumigatus and Curvularia lunata were not inhibited by any PDAT parameters tested. Continuous and pulsed irradiation using 2.7 J/cm produced similar results. Rose bengal PDAT successfully inhibits the in vitro growth of five fungi known to cause infectious keratitis. Differences in growth inhibition of the various fungi to multiple PDAT parameters suggest that susceptibilities to PDAT are unique among fungal species. These findings support modifying PDAT parameters based on the infectious etiology.

References

Jeng B . Challenges in the Management of Fungal Keratitis. JAMA Ophthalmol. 2017; 135(6):525-526. DOI: 10.1001/jamaophthalmol.2017.0722. View

Miller D . Update on the Epidemiology and Antibiotic Resistance of Ocular Infections. Middle East Afr J Ophthalmol. 2017; 24(1):30-42. PMC: 5433126. DOI: 10.4103/meajo.MEAJO_276_16. View

Lalitha P, Prajna N, Manoharan G, Srinivasan M, Mascarenhas J, Das M . Trends in bacterial and fungal keratitis in South India, 2002-2012. Br J Ophthalmol. 2014; 99(2):192-4. PMC: 7325420. DOI: 10.1136/bjophthalmol-2014-305000. View

Austin A, Lietman T, Rose-Nussbaumer J . Update on the Management of Infectious Keratitis. Ophthalmology. 2017; 124(11):1678-1689. PMC: 5710829. DOI: 10.1016/j.ophtha.2017.05.012. View

Gopinathan U, Garg P, Fernandes M, Sharma S, Athmanathan S, Rao G . The epidemiological features and laboratory results of fungal keratitis: a 10-year review at a referral eye care center in South India. Cornea. 2002; 21(6):555-9. DOI: 10.1097/00003226-200208000-00004. View

Prajna N, Srinivasan M, Mascarenhas J, Lalitha P, Rajaraman R, McClintic S . Visual Impairment in Fungal Versus Bacterial Corneal Ulcers 4 Years After Successful Antimicrobial Treatment. Am J Ophthalmol. 2019; 204:124-129. PMC: 8075352. DOI: 10.1016/j.ajo.2019.03.010. View

Bourcier T, Sauer A, Dory A, Denis J, Sabou M . Fungal keratitis. J Fr Ophtalmol. 2017; 40(9):e307-e313. DOI: 10.1016/j.jfo.2017.08.001. View

Mahmoudi S, Masoomi A, Ahmadikia K, Tabatabaei S, Soleimani M, Rezaie S . Fungal keratitis: An overview of clinical and laboratory aspects. Mycoses. 2018; 61(12):916-930. DOI: 10.1111/myc.12822. View

Prajna N, Krishnan T, Mascarenhas J, Rajaraman R, Prajna L, Srinivasan M . The mycotic ulcer treatment trial: a randomized trial comparing natamycin vs voriconazole. JAMA Ophthalmol. 2013; 131(4):422-9. PMC: 3769211. DOI: 10.1001/jamaophthalmol.2013.1497. View

10.

Prajna N, Krishnan T, Rajaraman R, Patel S, Shah R, Srinivasan M . Adjunctive Oral Voriconazole Treatment of Fusarium Keratitis: A Secondary Analysis From the Mycotic Ulcer Treatment Trial II. JAMA Ophthalmol. 2017; 135(6):520-525. PMC: 5847083. DOI: 10.1001/jamaophthalmol.2017.0616. View

11.

Sav H, Ozdemir H, Altinbas R, Kiraz N, Ilkit M, Seyedmousavi S . Virulence Attributes and Antifungal Susceptibility Profile of Opportunistic Fungi Isolated from Ophthalmic Infections. Mycopathologia. 2016; 181(9-10):653-61. DOI: 10.1007/s11046-016-0018-3. View

12.

Jackson B, Wilhelmus K, Hube B . The role of secreted aspartyl proteinases in Candida albicans keratitis. Invest Ophthalmol Vis Sci. 2007; 48(8):3559-65. DOI: 10.1167/iovs.07-0114. View

13.

Zhu W, Wojdyla K, Donlon K, Thomas P, Eberle H . Extracellular proteases of Aspergillus flavus. Fungal keratitis, proteases, and pathogenesis. Diagn Microbiol Infect Dis. 1990; 13(6):491-7. DOI: 10.1016/0732-8893(90)90081-6. View

14.

Wilhelmus K, Jones D . Curvularia keratitis. Trans Am Ophthalmol Soc. 2002; 99:111-30; discussion 130-2. PMC: 1359003. View

15.

Halili F, Arboleda A, Durkee H, Taneja M, Miller D, Alawa K . Rose Bengal- and Riboflavin-Mediated Photodynamic Therapy to Inhibit Methicillin-Resistant Staphylococcus aureus Keratitis Isolates. Am J Ophthalmol. 2016; 166:194-202. DOI: 10.1016/j.ajo.2016.03.014. View

16.

Durkee H, Arboleda A, Aguilar M, Martinez J, Alawa K, Relhan N . Rose bengal photodynamic antimicrobial therapy to inhibit Pseudomonas aeruginosa keratitis isolates. Lasers Med Sci. 2019; 35(4):861-866. PMC: 7261617. DOI: 10.1007/s10103-019-02871-9. View

17.

Arboleda A, Miller D, Cabot F, Taneja M, Aguilar M, Alawa K . Assessment of rose bengal versus riboflavin photodynamic therapy for inhibition of fungal keratitis isolates. Am J Ophthalmol. 2014; 158(1):64-70.e2. PMC: 4075940. DOI: 10.1016/j.ajo.2014.04.007. View

18.

Amescua G, Arboleda A, Nikpoor N, Durkee H, Relhan N, Aguilar M . Rose Bengal Photodynamic Antimicrobial Therapy: A Novel Treatment for Resistant Fusarium Keratitis. Cornea. 2017; 36(9):1141-1144. PMC: 5546001. DOI: 10.1097/ICO.0000000000001265. View

19.

Atalay H, Dogruman-Al F, Sarzhanov F, Ozmen M, Tefon A, Aribas Y . Effect of Riboflavin/Rose Bengal-Mediated PACK-CXL on Acanthamoeba Trophozoites and Cysts in Vitro. Curr Eye Res. 2018; 43(11):1322-1325. DOI: 10.1080/02713683.2018.1501074. View

20.

Zhu H, Alt C, Webb R, Melki S, Kochevar I . Corneal Crosslinking With Rose Bengal and Green Light: Efficacy and Safety Evaluation. Cornea. 2016; 35(9):1234-41. DOI: 10.1097/ICO.0000000000000916. View