High-intensity corneal collagen crosslinking with riboflavin and UVA in rat cornea.

Corneal collagen cross-linking (CXL) halts human corneal ectasias progression by increasing stromal mechanical stiffness. Although some reports describe that this procedure is effective in dealing with some infectious and immunologic corneal thinning diseases, there is a need for more animal models...

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Main Authors: Yirui Zhu, Peter S Reinach, Hanlei Zhu, Qiufan Tan, Qinxiang Zheng, Jia Qu, Wei Chen
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0179580&type=printable
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author Yirui Zhu
Peter S Reinach
Hanlei Zhu
Qiufan Tan
Qinxiang Zheng
Jia Qu
Wei Chen
author_facet Yirui Zhu
Peter S Reinach
Hanlei Zhu
Qiufan Tan
Qinxiang Zheng
Jia Qu
Wei Chen
author_sort Yirui Zhu
collection DOAJ
description Corneal collagen cross-linking (CXL) halts human corneal ectasias progression by increasing stromal mechanical stiffness. Although some reports describe that this procedure is effective in dealing with some infectious and immunologic corneal thinning diseases, there is a need for more animal models whose corneal thickness more closely resemble those occurring in these patients. To meet this need, we describe here high-intensity protocols that are safe and effective for obtaining CXL in rat corneas. Initially, a range of potentially effective UVA doses were evaluated based on their effectiveness in increasing tissue enzymatic resistance to dissolution. At UVA doses higher than a threshold level of 0.54 J/cm2, resistance to enzymatic digestion increased relative to that in non-irradiated corneas. Based on the theoretical threshold CXL dose, a CXL regimen was established in which the UVA tissue irradiance was 9 mW/cm2, which was delivered at doses of either 2.16, 2.7 or 3.24 J/cm2. Their dose dependent effects were evaluated on ocular surface morphological integrity, keratocyte apoptotic frequency, tissue thickness and endothelial cell layer density. Doses of 2.16 and 2.7 J/cm2 transiently decreased normal corneal transparency and increased thickness. These effects were fully reversed after 14 days. In contrast, 3.24 J/cm2 had more irreversible side effects. Three days after treatment, apoptotic frequency in the CXL-2.16 group was lower than that at higher doses. Endothelial cell losses remained evident only in the CXL-3.24 group at 42 days posttreatment. Stromal fiber thickening was evident in all the CXL-treated groups. We determined both the threshold UVA dose using the high-intensity CXL procedure and identified an effective dose range that provides optimal CXL with minimal transient side effects in the rat cornea. These results may help to provide insight into how to improve the CXL outcome in patients afflicted with a severe corneal thinning disease.
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spelling doaj.art-8195d1f39a9640e58d468aa714d0b2e32025-02-27T05:32:36ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01126e017958010.1371/journal.pone.0179580High-intensity corneal collagen crosslinking with riboflavin and UVA in rat cornea.Yirui ZhuPeter S ReinachHanlei ZhuQiufan TanQinxiang ZhengJia QuWei ChenCorneal collagen cross-linking (CXL) halts human corneal ectasias progression by increasing stromal mechanical stiffness. Although some reports describe that this procedure is effective in dealing with some infectious and immunologic corneal thinning diseases, there is a need for more animal models whose corneal thickness more closely resemble those occurring in these patients. To meet this need, we describe here high-intensity protocols that are safe and effective for obtaining CXL in rat corneas. Initially, a range of potentially effective UVA doses were evaluated based on their effectiveness in increasing tissue enzymatic resistance to dissolution. At UVA doses higher than a threshold level of 0.54 J/cm2, resistance to enzymatic digestion increased relative to that in non-irradiated corneas. Based on the theoretical threshold CXL dose, a CXL regimen was established in which the UVA tissue irradiance was 9 mW/cm2, which was delivered at doses of either 2.16, 2.7 or 3.24 J/cm2. Their dose dependent effects were evaluated on ocular surface morphological integrity, keratocyte apoptotic frequency, tissue thickness and endothelial cell layer density. Doses of 2.16 and 2.7 J/cm2 transiently decreased normal corneal transparency and increased thickness. These effects were fully reversed after 14 days. In contrast, 3.24 J/cm2 had more irreversible side effects. Three days after treatment, apoptotic frequency in the CXL-2.16 group was lower than that at higher doses. Endothelial cell losses remained evident only in the CXL-3.24 group at 42 days posttreatment. Stromal fiber thickening was evident in all the CXL-treated groups. We determined both the threshold UVA dose using the high-intensity CXL procedure and identified an effective dose range that provides optimal CXL with minimal transient side effects in the rat cornea. These results may help to provide insight into how to improve the CXL outcome in patients afflicted with a severe corneal thinning disease.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0179580&type=printable
spellingShingle Yirui Zhu
Peter S Reinach
Hanlei Zhu
Qiufan Tan
Qinxiang Zheng
Jia Qu
Wei Chen
High-intensity corneal collagen crosslinking with riboflavin and UVA in rat cornea.
PLoS ONE
title High-intensity corneal collagen crosslinking with riboflavin and UVA in rat cornea.
title_full High-intensity corneal collagen crosslinking with riboflavin and UVA in rat cornea.
title_fullStr High-intensity corneal collagen crosslinking with riboflavin and UVA in rat cornea.
title_full_unstemmed High-intensity corneal collagen crosslinking with riboflavin and UVA in rat cornea.
title_short High-intensity corneal collagen crosslinking with riboflavin and UVA in rat cornea.
title_sort high intensity corneal collagen crosslinking with riboflavin and uva in rat cornea
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0179580&type=printable
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