Rolando Arcelli¹, Chiara Ovidi⁶, Caterina Morera¹*, Giuseppe Lombardo^2,3, Marco Lombardo^3,4, Andrea Marchegiani⁵ and Rodolfo Gialletti¹

¹Department of Veterinary Medicine, Università degli studi di Perugia, Via San Costanzo, Perugia, Italy
²CNR-IPCF, Istituto Per i Processi Chimico-Fisici, Viale F. Stagno D’Alcontres, Messina, Italy
³Vision Engineering Italy SRL, Via Livenza, Rome, Italy
⁴Studio Italiano di Oftalmologia, Via Livenza, Rome, Italy
⁵School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, Matelica (Macerata), Italy
⁶Doctor of Veterinary Medicine Freelancer, Italy

*Corresponding Author: Caterina Morera, Department of Veterinary Medicine, Università degli studi di Perugia, Via San Costanzo, Perugia, Italy.

Received: December 05, 2022; Published: January 07, 2023

Abstract

Purpose: To assess the epithelial-stromal healing process after corneal phototherapy with riboflavin and UV-A of corneal ulcers, which were resistant to medical therapy, by means of Anterior Segment Optical Coherence Tomography (OCT; iVue optovue).

Procedure: 14 dogs (14 eyes), with corneal ulcer involving at least 1/3 of the stroma and not responding to medical therapy for at least 30 days, were included in this study. The corneal phototherapy consisted in the instillation of 0.1% riboflavin ophthalmic so lution on to the cornea for 20 minutes, followed by UV-A irradiation at 30 mW/cm2 for 3 minutes. Subjects underwent a complete ophthalmological examination on the day of treatment, after 7 days and then at an interval between 7 and 20 days until the resolution of the ulcer for a follow-up period up to 3 months. At each follow-up examination, the stromal and epithelial thickness of both the ulcerated area and the surrounding healthy areas were measured with OCT in order to evaluate the epithelial-stromal healing process.

Results: Healing of the ulcerative corneal lesion was achieved in 12.5 ± 4 days after corneal phototherapy in all cases. The OCT assessment of corneal lesions was valuable to assess objectively the course of the healing process.

Conclusions: OCT assessment provided useful information on corneal wound healing process after corneal phototherapy. The treatment has proven to be a safe and valid therapeutic option for chronic corneal ulcers no responders to medical therapy

Keywords: Corneal Phototherapy; Corneal Cross-Linking; UV-A; Riboflavin; Corneal Ulcers; OCT

References

1. Marcato PS. “Systematic veterinary pathology”. II, Milano: Edagricole (Second edition (2015).
2. Garg Prashant., et al. “Collagen Cross-Linking for Microbial Keratitis”. Middle East African Journal of Ophthalmology 1 (a2017): 18-23.
3. Bayraktar Serife., et al. “Corneal Collagen Cross-Linking in Pellucid Marginal Degeneration: 2 Patients, 4 Eyes”. Case Reports in Ophthalmological Medicine 2015 (2015): 1-4.
4. Maier Philip., et al. “Corneal Collagen Cross-Linking in the Stabilization of Keratoconus”. Deutsches Aerzteblatt Online 116 (2019): 184-190.
5. , et al. “The Outcome of Corneal Collagen Cross-Linking in Patients with Advanced Progressive Keratoconus: A 2-Year Follow-up Study”. Middle East African Journal of Ophthalmology 26.1 (2019): 11.
6. Gelatt KN., et al. “Veterinary ophthalmology”: two volume set, Hoboken: Wiley-Blackwell (2013, fifth edition (2013).
7. Michel e Lazard. “Treatment of stromal abscessation with corneal collagen cross-linking in two cats”. Veterinary Ophthalmology1 (2016).
8. Chen Xiangjun., et al. “Corneal Collagen Cross-Linking (CXL) in Thin Corneas”. Eye and Vision1 (2015): 15.
9. “Evaluation of accelerated collagen cross-linking for the treatment of refractory deep keratitis in eight dogs and 10 cats”. Veterinary Ophthalmology (2013): 1-10.
10. Pot Gallhofer., et al. “Treatment of bullous keratopathy with corneal collagen cross-linking in two dogs”. Veterinary Ophthalmology2 (2015): 168-173.
11. Michel e Lazard. “Treatment of pre-descemetic melting keratitis with corneal collagen cross-linking in three dogs”. Veterinary Ophthalmology (2016).
12. Pot Gallhofer., et al. “Corneal collagen cross-linking as treatment for infectious and non-infectious corneal melting in cats and dogs: results of a prospective, nonrandomized, controlled trial”. Veterinary Ophthalmology4 (2014): 250-260.
13. , et al. “Cornea Collagen Cross-Linking for Keratoconus: A Comparison between Accelerated and Conventional Methods”. Advanced Biomedical Research 6.1 (2017): 10.
14. “Evaluation of accelerated corneal collagen cross-linking for the treatment of bollous keratopathy in eight dogs”. Veterinary Ophthalmology 19.3 (2016: 250-255.
15. Huang Jinrong., et al. “Two-Year Topographic and Densitometric Outcomes of Accelerated (45 MW/Cm2) Transepithelial Corneal Cross-Linking for Keratoconus: A Case-Control Study”. BMC Ophthalmology1 (2018): 337.
16. Mastropasqua Leonardo. “Collagen Cross-Linking: When and How? A Review of the State of the Art of the Technique and New Perspectives”. Eye and Vision1 (2015): 19.
17. Perazzi Gomiero., et al. “An Assay System to Evaluate Riboflavin/UV-A Corneal Phototherapy Efficacy in a Porcine Corneal Organ Culture Model”. Animals730 (2020).
18. Telang Omkar Jagdish and E Vrunda Gangadhar Morepatil. “OCT (optical coherence tomography) as a diagnostic tool in corneal disorders”. Journal of Evidence Based Medicine and Healthcare88 (2017): 5119-5123.
19. Suter A., et al. “Septic keratitis in dogs, cats, and horses in Switzerland: associated bacteria and antibiotic susceptibility”. Veterinary Ophthalmology (2017): 1-10.
20. Tabibian David., et al. “PACK-CXL: Corneal Cross-Linking in Infectious Keratitis”. Eye and Vision1 (2016): 11.
21. Mikropoilos., et al. “Intraoperative Photoactivated Chromophore for Infectious Keratitis–Corneal Cross-Linking (PACK-CXL) During Penetrating Keratoplasty for the Management of Fungal Keratitis in an Immunocompromised Patient”. Ophthalmology and Therapy 8 (2019): 491-495.
22. “Evaluation of accelerated corneal collagen cross-linking for the treatment of melting keratitis in eight dogs”. Veterinary Ophthalmology 17.5 (2014): 358-367.
23. Lim Li., et al. “A Review of Corneal Collagen Cross-Linking - Current Trends in Practice Applications”. The Open Ophthalmology Journal1 (2018): 181-213.
24. Caruso Ciro., et al. “Corneal Cross-Linking: Evaluating the Potential for a Lower Power, Shorter Duration Treatment”. Cornea5 (2016): 659-662.
25. Spiess Pot and Florin e Hafezi. “Corneal collagen cross-linking (CXL) for the treatment of melting keratitis in cats and dogs: a pilot study”. Veterinary Ophthalmology1 (2014): 1-11.

Citation

Citation: Caterina Morera., et al. “Accelerated Cross-Linking for the Treatment of Chronic Corneal Ulcers and Evaluation of Healing with Optical Coherence Tomography (OCT)".Acta Scientific Veterinary Sciences 5.2 (2023): 02-17.

Copyright

Copyright: © 2023 Caterina Morera., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.