Keratomykose – Therapiestandards und aktuelle Entwicklungen

W. Behrens-Baumann; D. Finis; C. MacKenzie; M. Roth; G. Geerling

doi:10.1055/s-0035-1546032

Klinische Monatsblätter für Augenheilkunde, Inhaltsverzeichnis

Klin Monbl Augenheilkd 2015; 232(6): 754-764
DOI: 10.1055/s-0035-1546032

Übersicht

Georg Thieme Verlag KG Stuttgart · New York

Keratomykose – Therapiestandards und aktuelle Entwicklungen

Keratomycosis – Therapy Standards and New Developments

W. Behrens-Baumann

¹Universitätsaugenklinik, Otto-von-Guericke-Universität Magdeburg

,

D. Finis

²Augenklinik, Heinrich-Heine-Universität Düsseldorf

,

C. MacKenzie

³Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Heinrich-Heine-Universität Düsseldorf

,

M. Roth

²Augenklinik, Heinrich-Heine-Universität Düsseldorf

,

G. Geerling

²Augenklinik, Heinrich-Heine-Universität Düsseldorf

› Institutsangaben

Abstract

Zusammenfassung

Die mykotische Keratitis ist ein verhältnismäßig seltenes, aber sehr ernst zu nehmendes ophthalmologisches Krankheitsbild mit potenziell visusbedrohendem Verlauf. Seit etwa 2 Jahrzehnten ist eine Häufigkeitszunahme der Pilzkeratitis festzustellen, möglicherweise bedingt durch die vermehrte Verwendung von weichen Kontaktlinsen. Dieser Beitrag gibt einen Überblick über die typischen klinischen Zeichen und Symptome der Keratomykose und stellt Bewährtes sowie neue Entwicklungen und Erkenntnisse im Bereich der Diagnostik und Therapie der mykotischen Keratitis dar.

Abstract

Mycotic keratitis is a comparatively rare but serious ophthalmological disease, that can possibly lead to a severe loss of vision up to blindness. Over the last two decades an increase of cases with mycotic keratitis has been noticed, which is possibly caused by an increased use of soft contact lenses. This article gives an overview of the typical clinical signs and symptoms of keratomycosis, tried and tested diagnostics and therapy as well as new diagnostic and therapeutic developments and findings.

Schlüsselwörter

Mikrobiologie - Infektiologie - Kornea

Key words

microbiology - infectious diseases - cornea

Volltext

Referenzen

Literatur
1 Leber T. Keratomycosis aspergillina als Ursache von Hypopyonkeratitis. Graefe Arch Ophthal 1879; 25: 285-301
2 Schirmer O. Ein Fall von Schimmelpilzkeratitis. Graefe Arch Ophthal 1896; 42: 131-139
3 Uhthoff W. Beiträge zur pathologischen Anatomie des Auges. Graefe Arch Ophthal 1883; 29: 178-181
4 Uhthoff W, Axenfeld T. Beiträge zur pathologischen Anatomie und Bakteriologie der eitrigen Keratitis des Menschen. Graefe Arch Ophthal 1896; 42: 114-127
5 Hoffmann DH, Schmitz R. Die experimentelle Keratomykose als Beitrag zur Frage des Cortisonschadens am Auge. Ein vorläufiger Bericht. Mykosen 1963; 6: 12-20
6 Neuhann T, Blassmann K, Roth HW. Pilzwachstum auf weichen Kontaktlinsen. Klin Monatsbl Augenheilkd 1978; 173: 648-653
7 Yamamoto GK, Pavan-Langston D et al. Stowe GC 3rd et al. Fungal invasion of a therapeutic soft contact lens and cornea. Ann Ophthalmol 1979; 11: 1731-1735
8 Fleiszig SM, Evans DJ. Pathogenesis of contact lens-associated microbial keratitis. Optom Vis Sci 2010; 87: 225-232
9 Butler TK, Males JJ, Robinson LP et al. Six-year review of Acanthamoeba keratitis in New South Wales, Australia: 1997–2002. Clin Experiment Ophthalmol 2005; 33: 41-46
10 Imamura Y, Chandra J, Mukherjee PK et al. Fusarium and Candida albicans biofilms on soft contact lenses: model development, influence of lens type, and susceptibility to lens care solutions. Antimicrob Agents Chemother 2008; 52: 171-182
11 Behrens-Baumann W. Mycosis of the Eye and its Adnexa. Basel: Karger Medical and Scientific Publishers; 1999: 68-107
12 Behrens-Baumann W. Diagnostik und Therapie der Keratomykose. Ophthalmologe 2009; 106: 471-481
13 Nielsen SE, Nielsen E, Julian HO et al. Incidence and clinical characteristics of fungal keratitis in a Danish population from 2000 to 2013. Acta Ophthalmol 2015; 93: 54-58
14 Kaufman HE, Wood RM. Mycotic Keratitis. Am J Ophthalmol 1965; 59: 993-1000
15 Thomas PA. Fungal infections of the cornea. Eye (Lond) 2003; 17: 852-862
16 Naumann GOH. Pathologie des Auges I. Berlin: Springer; 1997: 507-692
17 Thomas PA, Leck AK, Myatt M. Characteristic clinical features as an aid to the diagnosis of suppurative keratitis caused by filamentous fungi. Br J Ophthalmol 2005; 89: 1554-1558
18 Yanoff M, Duker JS, Augsburger JJ. Ophthalmology. 4th ed. Elsevier Health Sciences; 2014: 217-227
19 Badenoch PR, Coster DJ. Antimicrobial activity of topical anaesthetic preparations. Br J Ophthalmol 1982; 66: 364-367
20 Pleyer U, Behrens-Baumann W. Bakterielle Keratitis – Aktuelle Aspekte zur Diagnostik. Ophthalmologe 2007; 104: 9-14
21 Rostane H, Saint-Jean C, Batellier L et al. Effects of topical anaesthetics and fluorescein on the real-time PCR used for the diagnosis of Herpesviruses and Acanthamoeba keratitis. Br J Ophthalmol 2006; 90: 1354-1356
22 Kaye SB, Rao PG, Smith G et al. Simplifying collection of corneal specimens in cases of suspected bacterial keratitis. J Clin Microbiol 2003; 41: 3192-3197
23 Pakzad-Vaezi K, Levasseur SD, Schendel S et al. The corneal ulcer one-touch study: a simplified microbiological specimen collection method. Am J Ophthalmol 2015; 159: 37-43
24 McLeod SD, Kumar A, Cevallos V et al. Reliability of transport medium in the laboratory evaluation of corneal ulcers. Am J Ophthalmol 2005; 140: 1027-1031
25 Kuo IC, Cevallos V, Troyer R et al. Efficacy of transport media use versus direct inoculation of blood agar plates in the microbiologic evaluation of experimental Streptococcus pneumoniae keratitis. Cornea 2003; 22: 249-253
26 Niki M, Eguchi H, Hayashi Y et al. Ineffectiveness of intrastromal voriconazole for filamentous fungal keratitis. Clin Ophthalmol 2014; 8: 1075-1079
27 Brooks JG, Coster DJ. Non-ulcerative fungal keratitis diagnosed by posterior lamellar biopsy. Aust N Z J Ophthalmol 1993; 21: 115-119
28 Bharathi MJ, Ramakrishnan R, Meenakshi R et al. Microbiological diagnosis of infective keratitis: comparative evaluation of direct microscopy and culture results. Br J Ophthalmol 2006; 90: 1271-1276
29 Copeland R, Afshari N. Copeland and Afshariʼs Principles and Practice of Cornea. 1st. ed. New Delhi: Jaypee Brothers Medical Publishers; 2012: 195-213
30 Alfonso EC. Genotypic identification of Fusarium species from ocular sources: comparison to morphologic classification and antifungal sensitivity testing (an AOS thesis). Trans Am Ophthalmol Soc 2008; 106: 227-239
31 Richardson MD, Warnock DW. Fungal Infection. 3rd. ed. Chichester: Blackwell Publishers; 2003: 14-28
32 Das S, Sharma S, Kar S et al. Is inclusion of Sabouraud dextrose agar essential for the laboratory diagnosis of fungal keratitis?. Indian J Ophthalmol 2010; 58: 281-286
33 Thomas PA, A Teresa P. Theodore J et al. PCR for the molecular diagnosis of mycotic keratitis. Expert Rev Mol Diagn 2012; 12: 703-718
34 Degorge S, Benallaoua D, Semoun O et al. New strategy for rapid diagnosis and characterization of keratomycosis. Ophthalmology 2012; 119: 945-950
35 Vengayil S, Panda A, Satpathy G et al. Polymerase chain reaction-guided diagnosis of mycotic keratitis: a prospective evaluation of its efficacy and limitations. Invest Ophthalmol Vis Sci 2009; 50: 152-156
36 Taravati P, Lam D, Van Gelder RN. Role of molecular diagnostics in ocular microbiology. Curr Ophthalmol Rep 2013; 1: 181-189
37 Ferrer C, Alio JL. Evaluation of molecular diagnosis in fungal keratitis. Ten years of experience. J Ophthalmic Inflamm Infect 2011; 1: 15-22
38 Kim E, Chidambaram JD, Srinivasan M et al. Prospective comparison of microbial culture and polymerase chain reaction in the diagnosis of corneal ulcer. Am J Ophthalmol 2008; 146: 714-723.e1
39 Bader O, Weig M, Taverne-Ghadwal L et al. Improved clinical laboratory identification of human pathogenic yeasts by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Clin Microbiol Infect 2011; 17: 1359-1365
40 De Carolis E, Posteraro B, Lass-Flörl C et al. Species identification of Aspergillus, Fusarium and Mucorales with direct surface analysis by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Clin Microbiol Infect 2012; 18: 475-484
41 Jung JS, Popp C, Sparbier K et al. Evaluation of matrix-assisted laser desorption ionization-time of flight mass spectrometry for rapid detection of β-lactam resistance in Enterobacteriaceae derived from blood cultures. J Clin Microbiol 2014; 52: 924-930
42 Vaddavalli PK, Garg P, Sharma S et al. Role of confocal microscopy in the diagnosis of fungal and acanthamoeba keratitis. Ophthalmology 2011; 118: 29-35
43 Nielsen E, Heegaard S, Prause JU et al. Fungal keratitis – improving diagnostics by confocal microscopy. Case Rep Ophthalmol 2013; 4: 303-310
44 Soliman W, Fathalla AM, El-Sebaity DM et al. Spectral domain anterior segment optical coherence tomography in microbial keratitis. Graefes Arch Clin Exp Ophthalmol 2013; 251: 549-553
45 Martone G, Pichierri P, Franceschini R et al. In vivo confocal microscopy and anterior segment optical coherence tomography in a case of alternaria keratitis. Cornea 2011; 30: 449-453
46 Hau SC, Dart JK, Vesaluoma M et al. Diagnostic accuracy of microbial keratitis with in vivo scanning laser confocal microscopy. Br J Ophthalmol 2010; 94: 982-987
47 Mølgaard-Nielsen D, Pasternak B, Hviid A. Use of oral fluconazole during pregnancy and the risk of birth defects. N Engl J Med 2013; 369: 830-839
48 Aust R, Kruse FE, Wildfeuer A et al. Fluconazolspiegel im Kammerwasser nach oraler Wirkstoffgabe beim Menschen. Ophthalmologe 1995; 92: 829-832
49 Urbak SF, Degn T. Fluconazole in the treatment of candida albicans endophthalmitis. Acta Ophthalmol 1992; 70: 528-529
50 Walsh TJ, Driscoll T, Milligan PA et al. Pharmacokinetics, safety, and tolerability of voriconazole in immunocompromised children. Antimicrob Agents Chemother 2010; 54: 4116-4123
51 Ally R, Schürmann D, Kreisel W et al. A randomized, double-blind, double-dummy, multicenter trial of voriconazole and fluconazole in the treatment of esophageal candidiasis in immunocompromised patients. Clin Infect Dis 2001; 33: 1447-1454
52 Lazarus HM, Blumer JL, Yanovich S et al. Safety and pharmacokinetics of oral voriconazole in patients at risk of fungal infection: a dose escalation study. J Clin Pharmacol 2002; 42: 395-402
53 Purkins L, Wood N, Ghahramani P et al. Pharmacokinetics and safety of voriconazole following intravenous- to oral-dose escalation regimens. Antimicrob Agents Chemother 2002; 46: 2546-2553
54 Vorwerk CK, Tuchen S, Streit F et al. Aqueous humor concentrations of topically administered caspofungin in rabbits. Ophthalmic Res 2009; 41: 102-105
55 Thiel MA, Zinkernagel AS, Burhenne J et al. Voriconazole concentration in human aqueous humor and plasma during topical or combined topical and systemic administration for fungal keratitis. Antimicrob Agents Chemother 2007; 51: 239-244
56 Lau D, Leung L, Ferdinands M et al. Penetration of 1 % voriconazole eye drops into human vitreous humour: a prospective, open-label study. Clin Experiment Ophthalmol 2009; 37: 197-200
57 Prajna NV, Krishnan T, Mascarenhas J et al. The mycotic ulcer treatment trial: a randomized trial comparing natamycin vs. voriconazole. JAMA Ophthalmol 2013; 131: 422-429
58 Giaconi JA, Marangon FB, Miller D et al. Voriconazole and fungal keratitis: a report of two treatment failures. J Ocul Pharmacol Ther 2006; 22: 437-439
59 Kalaiselvi G, Narayana S, Krishnan T et al. Intrastromal voriconazole for deep recalcitrant fungal keratitis: a case series. Br J Ophthalmol 2015; 99: 195-198
60 Prakash G, Sharma N, Goel M et al. Evaluation of intrastromal injection of voriconazole as a therapeutic adjunctive for the management of deep recalcitrant fungal keratitis. Am J Ophthalmol 2008; 146: 56-59
61 Sharma N, Chacko J, Velpandian T et al. Comparative evaluation of topical versus intrastromal voriconazole as an adjunct to natamycin in recalcitrant fungal keratitis. Ophthalmology 2013; 120: 677-681
62 Eguchi H, Hayashi Y, Miyamoto T et al. Ineffectiveness of intrastromal voriconazole for filamentous fungal keratitis. Clin Ophthalmol 2014; 1075
63 Shen YC, Wang CY, Tsai HY, Lee HN. Intracameral voriconazole injection in the treatment of fungal endophthalmitis resulting from keratitis. Am J Ophthalmol 2010; 149: 916-921
64 Breit SM, Hariprasad SM, Mieler WF et al. Management of endogenous fungal endophthalmitis with voriconazole and caspofungin. Am J Ophthalmol 2005; 139: 135-140
65 Shen YC, Wang MY, Wang CY et al. Clearance of intravitreal voriconazole. Invest Ophthalmol Vis Sci 2007; 48: 2238-2241
66 Sabatelli F, Patel R, Mann PA et al. In vitro activities of posaconazole, fluconazole, itraconazole, voriconazole, and amphotericin B against a large collection of clinically important molds and yeasts. Antimicrob Agents Chemother 2006; 50: 2009-2015
67 Ullmann AJ, Cornely OA, Burchardt A et al. Pharmacokinetics, safety, and efficacy of posaconazole in patients with persistent febrile neutropenia or refractory invasive fungal infection. Antimicrob Agents Chemother 2006; 50: 658-666
68 Groll AH, Lehrnbecher T. Posaconazole for paediatric patients: status of development and future perspectives. Mycoses 2008; 51 (Suppl. 02) S5-S11
69 Sponsel WE, Graybill JR, Nevarez HL et al. Ocular and systemic posaconazole (SCH-56592) treatment of invasive Fusarium solani keratitis and endophthalmitis. Br J Ophthalmol 2002; 86: 829-830
70 Bullock JD. An outbreak of fusarium keratitis associated with contact lens use in the northeastern United States. Cornea 2008; 27: 973-974
71 Störzinger D, Lichtenstern C, Swoboda S et al. Posaconazole in intensive care patients I: invasive fungal infections in surgical intensive care and case presentation. Mycoses 2008; 51 (Suppl. 02) S52-S57
72 Ullmann AJ, Lipton JH, Vesole DH et al. Posaconazole or fluconazole for prophylaxis in severe graft-versus-host disease. N Engl J Med 2007; 356: 335-347
73 Walsh TJ, Raad I, Patterson TF et al. Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controlled trial. Clin Infect Dis 2007; 44: 2-12
74 Rosa RH, Miller D, Alfonso EC. The changing spectrum of fungal keratitis in south Florida. Ophthalmology 1994; 101: 1005-1013
75 Behrens-Baumann W, Klinge B. Natamycin (Pimaricin) in der Behandlung der experimentellen Keratomykose. Fortschr Ophthalmol 1990; 87: 237-240
76 Lalitha P, Sun CQ, Prajna NV et al. In vitro susceptibility of filamentous fungal isolates from a corneal ulcer clinical trial. Am J Ophthalmol 2014; 157: 318-326
77 Srinivasan M. Fungal keratitis. Curr Opin Ophthalmol 2004; 15: 321-327
78 Behrens-Baumann W, Uter W, Ansorg R. Experimentelle Untersuchungen zur lokalen Therapie der Candida-Keratomykose mit Amphotericin B. Klin Monatsbl Augenheilkd 1987; 191: 125-128
79 Yoon KC, Jeong IY, Im SK et al. Therapeutic effect of intracameral amphotericin B injection in the treatment of fungal keratitis. Cornea 2007; 26: 814-818
80 Doft BH, Weiskopf J, Nilsson-Ehle I et al. Amphotericin clearance in vitrectomized versus nonvitrectomized eyes. Ophthalmology 1985; 92: 1601-1605
81 Carrasco MA, Genesoni G. Treatment of severe fungal keratitis with subconjunctival amphotericin B. Cornea 2011; 30: 608-611
82 Garcia-Valenzuela E, Song CD. Intracorneal injection of amphothericin B for recurrent fungal keratitis and endophthalmitis. Arch Ophthalmol 2005; 123: 1721-1723
83 Denning DW. Echinocandin antifungal drugs. Lancet 2003; 362: 1142-1151
84 Durand ML, Kim IK, DʼAmico DJ et al. Successful treatment of Fusarium endophthalmitis with voriconazole and Aspergillus endophthalmitis with voriconazole plus caspofungin. Am J Ophthalmol 2005; 140: 552-554
85 Neoh CF, Leung L, Misra A et al. Penetration of topically administered 0.5-percent caspofungin eye drops into human aqueous humor. Antimicrob Agents Chemother 2011; 55: 1761-1763
86 Reboli AC, Rotstein C, Pappas PG et al. Anidulafungin versus fluconazole for invasive candidiasis. N Engl J Med 2007; 356: 2472-2482
87 Korting HC, Kiencke P, Nelles S et al. Comparable efficacy and safety of various topical formulations of terbinafine in tinea pedis irrespective of the treatment regimen: results of a meta-analysis. Am J Clin Dermatol 2007; 8: 357-364
88 Sun XG, Wang ZX, Wang ZQ et al. Pharmacokinetics of terbinafine in the rabbit ocular tissues after topical administration. Ophthalmic Res 2007; 39: 81-83
89 Liang QF, Jin XY, Wang XL et al. Effect of topical application of terbinafine on fungal keratitis. Chin Med J (Engl) 2009; 122: 1884-1888
90 Hofmüller W, Tintelnot K, Seibold M et al. Terbinafin in fungal keratitis. (Noch unveröffentlicht, da der Pilz [vermutlich ein Coelomycet] noch nicht beschrieben wurde und derzeit im RKI Berlin und CBS Utrecht klassifiziert wird).
91 Ford JG, Agee S, Greenhaw ST. Successful medical treatment of a case of Paecilomyces lilacinus keratitis. Cornea 2008; 27: 1077-1079
92 Li L, Wang Z, Li R et al. In vitro evaluation of combination antifungal activity against Fusarium species isolated from ocular tissues of keratomycosis patients. Am J Ophthalmol 2008; 146: 724-728
93 Larkin DF, Kilvington S, Dart JK. Treatment of Acanthamoeba keratitis with polyhexamethylene biguanide. Ophthalmology 1992; 99: 185-191
94 Reinhard T, Behrens-Baumann W. Antiinfektiöse medikamentöse Therapie in der Augenheilkunde – Teil 4: Akanthamöben. Klin Monatsbl Augenheilkd 2006; 223: 485-492
95 Fiscella RG, Moshifar M, Messick CR et al. Polyhexamethylene biguanide (PHMB) in the treatment of experimental Fusarium keratomycosis. Cornea 1997; 16: 447-449
96 Behrens-Baumann W, Seibold M, Hofmüller W et al. Benefit of polyhexamethylene biguanide in Fusarium keratitis. Ophthalmic Res 2012; 48: 171-176
97 Behrens-Baumann W. Ist die fixe Kombination Kortikosteroid/Antibiotikum am Auge indiziert?. Z Prakt Augenheilkd 1995; 16: 361-366
98 Newmark E, Ellison AC, Kaufman HE. Combined pimaricin and dexamethasone therapy of keratomycosis. Am J Ophthalmol 1971; 71: 718-722
99 Francois J, Rijsselaere M. Corticosteroids and ocular mycoses: experimental study. Ann Ophthalmol 1974; 6: 207-217
100 Graf K. Über den Einfluss von Kortison auf das Entstehen von Keratomykosen am Kaninchenauge durch saprophytaere Pilze des menschlichen Bindehautsackes. Klin Monatsbl Augenheilkd 1963; 143: 356-362
101 Hasany SM, Basu PK, Kazdan JJ. Production of corneal ulcer by opportunistic and saprophytic fungi. 1. The effect of pretreatment of fungi with steroid. Can J Ophthalmol 1973; 8: 119-131
102 Hoffmann DH, Schmitz R. Untersuchungen zum Einfluß des Cortisons auf die experimentelle Candidamykose der Kaninchenhornhaut. Graefe Arch Ophthal 1963; 166: 260-276
103 Louria DB, Fallon N, Browne HG. The influence of cortisone on experimental fungus infections in mice. J Clin Invest 1960; 39: 1435-1449
104 OʼDay DM, Moore TE, Aronson SB. Deep fungal corneal abscess. Combined corticosteroid therapy. Arch Ophthalmol 1971; 86: 414-419
105 Schreiber W, Olbrisch A, Vorwerk CK et al. Combined topical fluconazole and corticosteroid treatment for experimental Candida albicans keratomycosis. Invest Ophthalmol Vis Sci 2003; 44: 2634-2643
106 Roberts SS. Nystatin in monilia keratoconjunctivitis; a case report. Am J Ophthalmol 1957; 44: 108-109
107 Perry HD, Doshi SJ, Donnenfeld ED et al. Topical cyclosporin A in the management of therapeutic keratoplasty for mycotic keratitis. Cornea 2002; 21: 161-163
108 Iseli HP, Thiel MA, Hafezi F et al. Ultraviolet A/riboflavin corneal cross-linking for infectious keratitis associated with corneal melts. Cornea 2008; 27: 590-594
109 Anwar HM, El-Danasoury AM, Hashem AN. Corneal collagen crosslinking in the treatment of infectious keratitis. Clin Ophthalmol 2011; 5: 1277-1280
110 Müller L, Thiel MA, Kipfer-Kauer AI et al. Corneales Crosslinking als zusa¨tzliche Therapieoption bei einschmelzender Hornhaut: eine Fall-Serie. Klin Monatsbl Augenheilkd 2012; 229: 411-415
111 Price MO, Tenkman LR, Schrier A et al. Photoactivated riboflavin treatment of infectious keratitis using collagen cross-linking technology. J Refract Surg 2012; 28: 706-713
112 Li Z, Jhanji V, Tao X et al. Riboflavin/ultravoilet light-mediated crosslinking for fungal keratitis. Br J Ophthalmol 2013; 97: 669-671
113 Shetty R, Nagaraja H, Jayadev C et al. Collagen crosslinking in the management of advanced non-resolving microbial keratitis. Br J Ophthalmol 2014; 98: 1033-1035
114 Said DG, Elalfy MS, Gatzioufas Z et al. Collagen cross-linking with photoactivated riboflavin (PACK-CXL) for the treatment of advanced infectious keratitis with corneal melting. Ophthalmology 2014; 121: 1377-1382
115 Ammermann C, Cursiefen C, Hermann M. Antimikrobielles Crosslinking der Hornhaut zur Vermeidung der Keratoplastik à chaud: retrospektive Fallserie. Klin Monatsbl Augenheilkd 2014; 231: 619-625
116 Martins SAR, Combs JC, Noguera G et al. Antimicrobial efficacy of riboflavin/UVA combination (365 nm) in vitro for bacterial and fungal isolates: a potential new treatment for infectious keratitis. Invest Ophthalmol Vis Sci 2008; 49: 3402-3408
117 Tayapad JB, Viguilla AQ, Reyes JM. Collagen cross-linking and corneal infections. Curr Opin Ophthalmol 2013; 24: 288-290
118 Choi KS, Yoon SC, Rim TH et al. Effect of voriconazole and ultraviolet-A combination therapy compared to voriconazole single treatment on Fusarium solani fungal keratitis. J Ocul Pharmacol Ther 2014; 30: 381-386
119 Arboleda A, Miller D, Cabot F et al. Assessment of rose bengal versus riboflavin photodynamic therapy for inhibition of fungal keratitis isolates. Am J Ophthalmol 2014; 158: 64-70.e2
120 Behrens-Baumann W. Ergebnisse der Keratoplastik à chaud. Klin Monatsbl Augenheilkd 1984; 185: 25-27
121 Behrens-Baumann W. Zur klinischen Diagnose der Pilzkeratitis. Z Prakt Augenheilkd 2010; 577-580