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Carolina Mercado, Salomon Merikansky, Jaime D. Martinez, Jean-Marie Parel,
and Guillermo Amescua
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine,
Miami, Florida
Purpose: To describe the utility of rose Bengal photodynamic therapy (RB-PDT) in treating Pseudomonas sclerokeratitis.
Methods: We reviewed retrospectively the charts of patients with culture-proven sclerokeratitis who underwent treatment with RB-PDT to prevent ocular perforation and reported their outcomes.
Results: We included 5 patients with Pseudomonas keratitis with concomitant infectious necrotizing scleritis. We noticed a resolution of the infection in all cases. One patient with pan-resistant Pseudomonas sclerokeratitis required 2 RB-PDT treatments due to persistent melting. None of the patients required enucleation. The mean time to resolution after RB-PDT was 16,6 days (range 6-30 days), and the overall course of infection averaged 39 days. All patients were treated with an oral 4th generation fluoroquinolone, topical tobramycin, and ciprofloxacin. The patient with pan-resistant Pseudomonas required treatment with topical imipenem as well. In the first 2 months of follow-up after resolution, no statistically significant improvements in visual acuity have been noted in 3 patients; none of these patients have yet undergone any subsequent procedures for visual rehabilitation.
Conclusions: RB-PDT is a feasible option to halt the progression of infectious necrotizing scleritis caused by Pseudomonas, especially in cases of impending perforation.
Disclosure: N (Mercado, Merikansky, Martinez; P (Parel, Amescua)
Ocular Microbiology and Immunology Group, Inc. 