The impact of corticosteroid therapy on the bacterial corneal ulcer healing process
https://doi.org/10.21516/2072-0076-2020-13-3-61-68
Abstract
Purpose: to conduct a clinical and morphological study of the role of corticosteroids in the healing of the ulcerative defect on an experimental model of the bacterial corneal ulcer.
Material and methods. The developed model of the bacterial corneal ulcer was used. Rabbits with bacterial corneal ulcer were divided into 4 groups of 10 animals (10 eyes) each. Group 1 received local antibacterial treatment. Groups 2 and 3 additionally received injections of 0.2–0.3 ml of Dexamethasone 0.1 % solution once per day (parabulbarly or under the skin of the back, respectively). Group 4 received no treatment but was checked clinically after ulcer modeling. Structural changes in eye tissues were assessed by histopathological examination using an examination on a Leica microscope system with a magnification of 100 to 600.
Results. Addition of corticosteroids in the early period of bacteria ulcer treatment contributes to an inhibition of the inflammatory process, reduces the action of collagenolysis processes and the size of the ulcer defect, and suppresses angiogenesis, which leads to an improvement in scar tissue quality.
Conclusion. Topical parabulbar injections of corticosteroids adding to the treatment topically in the form of parabulbar injections of corticosteroids contributes to changes in the emerging fibrous tissue which fills the ulcerous defect: a thin scar is formed, which is optically useful.About the Authors
V. V. Neroev
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Vladimir V. Neroev — Academician of the Russian Academy of Sciences, Dr. of Med. Sci., professor, director.
14/19, Sadovaya-Chernogryazskaya st., Moscow, 105062
E. V. Yani
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Elena V. Yani — Cand. of Med. Sci., head of department of infectious and allergic eye diseases.
14/19, Sadovaya-Chernogryazskaya st., Moscow, 105062
I. P. Khoroshilova-Maslova
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Inna P. Khoroshilova-Maslova — Dr. of Med. Sci., professor, head of department of pathological anatomy and histology.
14/19, Sadovaya-Chernogryazskaya st., Moscow, 105062
V. A. Golikova
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Viktorija A. Golikova — PhD student, department of infectious and allergic eye diseases.
14/19, Sadovaya-Chernogryazskaya st., Moscow, 105062
References
1. Tuli S.S., Schultz G.S., Downer D.M. Science and strategy for preventing and managing corneal ulceration. Ocul. Surf. 2007; 5: 23–39. doi: 10.1016/s1542-0124(12)70050-2
2. Evans D.J., Fleiszig S.M.J. Why does the healthy cornea resist Pseudomonas aeruginosa infection Am. J. Ophthalmol. 2013; 155 (6): 961–70. doi:10.1016/j.ajo.2013.03.00
3. Kasparova Evg.A. Purulent corneal ulcers: etiology, pathogenesis, classification. Vestnik oftal'mologii. 2015; 131 (5): 87–97 ( in Russian). doi: 10.17116/oftalma2015131587-97
4. Chen L., Hazlett L.D. Human corneal epithelial extracellular matrix perlecan serves as a site for Pseudomonas aeruginosa binding. Curr. Eye Res. 2001; 22 (1): 19–27. doi:10.1076/ceyr.22.1.19.6973
5. Marquart M.E., O’Callaghan R.J. Infectious keratitis: secreted bacterial proteins that mediate corneal damage. J. Ophthalmol. 2013; 2013:369094. doi:10.1155/2013/369094
6. Ostashevsky V.L., Gorgiladze T.U. The therapeutic effect of contrykal instillations in purulent ulcerative keratitis. Ophthalmological journal (Ukraine). 1984; 6: 350–3 (in Russian).
7. Bukowiecki A., Hos D., Cursiefen C., Eming S.A. Wound-healing studies in cornea and skin: parallels, differences and opportunities. Int. J. Mol. Sci. 2017 Jun; 18 (6): 1257. doi: 10.3390/ijms18061257
8. Fleiszig S.M., Evans D.J. The pathogenesis of bacterial keratitis: studies with Pseudomonas aeruginosa. Clin. Exp. Optom. 2002; 85: 271–8. doi:10.1111/j.1444-0938.2002.tb03082.x
9. Tuli S.S., Schultz G.S., Downer D.M. Science and strategy for preventing and managing corneal ulceration. Ocul. Surf. 2007 Jan; 5 (1): 23–39. doi: 10.1016/s1542-0124(12)70050-2
10. Chang J.H., Garg N., Lunde E., et al. Corneal neovascularization: an antiVEGF therapy review. Surv. Ophthalmol., 2012; 57: 415–29. doi: 10.1016/j. survophthal.2012.01.007
11. Chang J.H., Gabison E.E., Kato T., Aza D.T. Corneal neovascularization. Curr. Opin. Ophthalmol. 2001; 12: 242–9. doi:10.1097/00055735-200108000-00002
12. Shaik-Dasthagirisaheb Y.B., Varvara G., Murmura G., et al. Vascular endothelial growth factor (VEGF), mast cells and inflammation. Int. J. Immunopathol. Pharmacol. 2015; 26: 327–35. doi: 10.1177/039463201302600206
13. Srinivasan M., Lalitha P., Mahalakshmi R. Corticosteroids for bacterial corneal ulcers. Br. J. Ophthalmol. 2009; 93 (2): 198–202. doi: 10.1136/bjo.2008.147298
14. Hindman H.B., Patel S.B., Jun A.S. Rationale for adjunctive topical corticosteroids in bacterial keratitis. Arch. Ophthalmol. 2009; 127 (1): 97–102. doi: 10.1001/archophthalmol.2008.504
15. Ohadi C., Litwin K.L., Moreira H. Anti-inflammatory therapy and outcome in a guinea pig model of Pseudomonas keratitis. Cornea. 1992; 11 (5): 398–403.
16. Badenoch P.R., Hay G.J., McDonald P.J., Coster D.J. A rat model of bacterial keratitis: effect of antibiotics and corticosteroid. Arch. Ophthalmol. 1985; 103 (5): 718–22.
17. Fel A., Aslangul E., Le Jeunne C. Eye and corticosteroid's use. Presse Med. 2012; 41: 414–21. doi: 10.1016/j.lpm.2012.02.001
18. Shakiba Y., Mansouri K., Arshadi D., Rezaei N. Corneal neovascularization: molecular events and therapeutic options. Recent Pat. Inflamm. Allergy Drug. Discov. 2009; 3: 221–31. doi:10.2174/187221309789257450
19. Hos D., Saban D.R., Bock F., et al. Suppression of inflammatory corneal lymphagniogenesis by application of topical corticosteroids. Arch. Ophthalmol. 2011. 129: 445–52. doi:0.1001/archophthalmol.2011.42
20. Tuli S.S. Topical corticosteroids in the management of bacterial keratitis. Curr. Ophthalmol. Rep. 2013 Dec; 1 (4). doi:10.1007/s40135-013-0026-0
21. Den S., Sotozono C., Kinoshita S., Ikeda T. Efficacy of early systemic betamethasone or cyclosporin A after corneal alkali injury via inflammatory cytokine reduction. Acta Ophthalmol. Scand. 2004; 82: 195–9. doi: 10.1111/j.1600-0420.2004.00229.x
22. Yi K., Chung T.Y., Hyon J.Y., et al. Combined treatment with antioxidants and immunosuppressants on cytokine release by human peripheral blood mononuclear cells — chemically injured keratocyte reaction. Mol. Vis. 2011; 17: 2665–71. PMID:22065919
23. Srinivasan M., Mascarenhas J., Rajaraman R. Steroids for corneal ulcers trial group. corticosteroids for bacterial keratitis: the Steroids for Corneal Ulcers Trial (SCUT). Arch. Ophthalmol. 2012; 130 (2): 143–50. doi: 10.1001/archophthalmol.2011.315
24. Bikbov M.M., Nikitin N.A., Surkova V.K., Zaynullina N.B. Method of modeling bacterial keratitis. Patent RU, N2480845 (in Russian).
25. Panova I.G., Markitantova Y.V., Smirnova Y.A., Zinovieva R.D. Moleculargenetic mechanisms of cornea morphogenesis. Biology Bulletin. 2015; 42 (2): 83–91. doi: 10.7868/s0002332915020071
26. Simirskii V.N. Regeneration and fibrosis of corneal tissues. Ontogenes. 2014; 45 (5): 314–25 (in Russian). doi:10.7868/s0475145014050097
27. Hassell J.R., Birk D.E. The molecular basis of corneal transparency. Exp. Eye Res. 2010; 91 (3): 326–35. doi:10.1016/j.exer.2010.06.021
28. Neroev V.V., Yani E.V., Golikova V.A., Pozdnyakova V.V. Experimental evaluation of bacterial corneal ulcer treatment plans using glucocorticosteroid. Russian ophthalmological journal. 2020; 13 (2): 71–7 (In Russian). https://doi.org/10.21516/2072-0076-2020-13-2-71-77
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For citations:
Neroev V.V., Yani E.V., Khoroshilova-Maslova I.P., Golikova V.A. The impact of corticosteroid therapy on the bacterial corneal ulcer healing process. Russian Ophthalmological Journal. 2020;13(3):61-68. (In Russ.) https://doi.org/10.21516/2072-0076-2020-13-3-61-68
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