Challenges of corneal infections

ABSTRACT

Introduction: Ocular infections remain an important cause of blindness worldwide and represent a challenging public health concern. In this regard, microbial keratitis due to fungal, bacterial, or viral infection can result in significant vision loss secondary to corneal scarring or surface irregularity. Left untreated corneal perforation and endophthalmitis can result, leading to loss of the eye. Rigorously studied animal models of disease pathogenesis have provided novel information that suggests new modes of treatment that may be efficacious clinically and emerging clinical data is supportive of some of these discoveries.

Areas covered: This review focuses on advances in our understanding of disease pathogenesis in animal models and clinical studies and how these relate to improved clinical treatment. We also discuss a novel approach to treatment of microbial keratitis due to infection with these bacterial pathogens using PACK-CXL and recommend increased basic and clinical studies to address and refine the efficacy of this procedure.

Expert commentary: Because resistance to antibiotics has developed over time to these bacterial pathogens, caution must be exercised in treatment. Attractive novel modes of treatment that hold new promise for further investigation include lipid based therapy, as well as use of small molecules that bind deleterious specific host responsive molecules and use of microRNA based therapies.

KEYWORDS:

• Microbial keratitis
• animal models
• pathogenesis
• clinical studies
• treatment

Declaration of interest

The authors were supported by NIH/NEI R01EY016058 and P30EY004068 grants and a 2012 Alcon Research award received by L. Hazlett. S. Suvas has received the grant NIH/NEI R01 R01EY022417. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This work was supported by the National Institutes of Health, National Eye Institute: [Grant Number P30 EY004068,R01EY022417,R01EY016058].