Vitamin B-based treatment for corneal disease may offer some patients a permanent solution

The cornea is normally rounded, but with keratoconus, may bulge and become cone-shaped. Credit: AAO Ophthalmic Images

Patients in the United States who have the cornea-damaging disease keratoconus may soon be able to benefit from a new treatment that is already proving effective in Europe and other parts of the world. The treatment, called collagen crosslinking, improved vision in almost 70 percent of patients treated for keratoconus in a recent three-year clinical trial in Milan, Italy. The treatment is in clinical trials in the United States and is likely to receive FDA approval in 2012. The results of the Milan study are being presented today at the 115th Annual Meeting of the American Academy of Ophthalmology in Orlando, Florida.

In a session titled Long-term Results of Corneal Crosslinking for Keratoconus, Paolo Vinciguerra, MD will describe the treatment and three-year follow up of more than 250 keratoconus patients who received collagen crosslinking at his clinic. Sixty-eight percent of the 500 eyes treated gained significant , with their results remaining stable at the end of the follow-up period. Patients over age 18 were most likely to improve.

In the collagen crosslinking procedure, riboflavin (vitamin B) is applied to the cornea, which is then exposed to a specific form of ultraviolet light. regenerate with new bonds forming between them, increasing corneal stiffness and strength. The treatment also combats the causes of keratoconus, reducing the chance that it will recur. The rest of the eye receives only minimal during treatment. Dr. Vinciguerra's new study confirms that adverse effects are rare. Previous research by his team indicated no loss of corneal endothelial cell, a measurement used to assess the safety of corneal treatments, in patients who received collagen crosslinking.

"For many people with keratoconus, collagen crosslinking can provide a better and more permanent solution to their ," said Dr. Vinciguerra. "Given that no current treatment in use in the U.S. offers permanent correction, this effective option represents a significant advance for corneal medicine."

One in 2,000 people in the United States and worldwide are diagnosed with keratoconus, a disease that damages the collagen fibers that form the structure of the cornea, which is the outer surface of the eye. The cornea's crucial task is to focus, or "refract," incoming light toward the eye's lens. To perform properly, the cornea needs to be rounded, like the surface of a ball. As keratoconus worsens and the cornea becomes thinner, it may bulge outward in a cone shape, causing nearsightedness and/or astigmatism, making clear vision impossible. As the number of fibers and links between them decline, the cornea loses up to 50 percent of its normal stiffness.

Standard treatments in the U.S., such as specialized eyeglasses, contact lenses, or implanted lenses, cannot permanently correct keratoconus, and none of these treatments address the underlying causes. Severe keratoconus often requires corneal transplant.

Provided by American Academy of Ophthalmology

not rated yet
add to favorites email to friend print save as pdf

Related Stories

1 donor cornea, 2 patients helped

Feb 01, 2011

German researcher Claus Cursiefen, MD, also affiliated with Harvard School of Medicine, reports good results with a new surgical strategy that uses a single donor cornea to help two patients with differing corneal diseases. ...

Recommended for you

Where Ebola battles are won

6 hours ago

(HealthDay)—Four hospitals that are home to advanced biocontainment facilities have become America's ground zero in the treatment of Ebola patients.

Depression tied to worse lumbar spine surgery outcomes

9 hours ago

(HealthDay)—Depressive symptoms are associated with poorer long-term outcome in patients undergoing surgery for lumbar spinal stenosis (LSS), according to research published in the Oct. 1 issue of The Sp ...

Ebola death toll edging to 4,900 mark: WHO

9 hours ago

The death toll in the world's worst-ever Ebola outbreak has edged closer to 4,900, while almost 10,000 people have now been infected, new figures from the World Health Organization showed Wednesday.

US to track everyone coming from Ebola nations

10 hours ago

U.S. authorities said Wednesday that everyone traveling into the U.S. from Ebola-stricken nations will be monitored for symptoms for 21 days. That includes returning American aid workers, federal health employees ...

User comments