.: ORİJİNAL ARAŞTIRMA
The Effect of Coenzyme Q10 Eye Drop on Corneal Wound Healing in the Treatment of Bacterial Keratitis: A Prospective Clinical Study
Bakteriyel Keratit Tedavisinde Koenzim Q10 Göz Damlasının Korneal Yara İyileşmesi Üzerine Etkisi: Prospektif Klinik Çalışma
Turkiye Klinikleri J Ophthalmol. 2024;33(1):1-6
doi: 10.5336/ophthal.2023-97967
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: We aimed to evaluate the effectiveness and safety of Coenzyme Q10 (CoQ10) eye drops on corneal wound healing in bacterial keratitis. Material and Methods: Patients who were hospitalized and treated for bacterial keratitis were included in the study. The age, gender, and the affected eyes of the patients were recorded. The patients underwent a complete ophthalmologic examination and the presence or absence of hypopyon was recorded. The size of the corneal ulcer was measured horizontally and vertically. Patients were randomly divided into 2 groups. Both groups received topical antibiotics and cyclopentolate drops. In addition to the first group, CoQ10 eye drop 4×1 treatment was added. Corneal ulcer images were taken before the treatment and recorded daily after the treatment initiation, until the ulcer healed. Results: The mean age of the 32 patients included in the study was 51.16±25.31 (7-90) years, 20 (62.5%) were male and 12 (37.5%) were female. There was no statistically significant difference in terms of age, gender, right and left eye involvement, hypopyon presence and corneal ulcer size in CoQ10 eye drop group (n=16) and control group (n=16) (p>0.05). The mean healing time was 12.25±6.02 days in CoQ10 eye drop group and 19±12.9 days in control group (p=0.076). Conclusion: The effect of CoQ10 eye drops in the treatment of bacterial keratitis with corneal ulcers was not found to be statistically significant. However, it can be considered as an adjuvant agent in terms of shortening the healing time. There is a need for more extensive series, randomized, prospective clinical trials.
Keywords: Corneal ulcer; keratitis; Coenzyme Q10
Objective: We aimed to evaluate the effectiveness and safety of Coenzyme Q10 (CoQ10) eye drops on corneal wound healing in bacterial keratitis. Material and Methods: Patients who were hospitalized and treated for bacterial keratitis were included in the study. The age, gender, and the affected eyes of the patients were recorded. The patients underwent a complete ophthalmologic examination and the presence or absence of hypopyon was recorded. The size of the corneal ulcer was measured horizontally and vertically. Patients were randomly divided into 2 groups. Both groups received topical antibiotics and cyclopentolate drops. In addition to the first group, CoQ10 eye drop 4×1 treatment was added. Corneal ulcer images were taken before the treatment and recorded daily after the treatment initiation, until the ulcer healed. Results: The mean age of the 32 patients included in the study was 51.16±25.31 (7-90) years, 20 (62.5%) were male and 12 (37.5%) were female. There was no statistically significant difference in terms of age, gender, right and left eye involvement, hypopyon presence and corneal ulcer size in CoQ10 eye drop group (n=16) and control group (n=16) (p>0.05). The mean healing time was 12.25±6.02 days in CoQ10 eye drop group and 19±12.9 days in control group (p=0.076). Conclusion: The effect of CoQ10 eye drops in the treatment of bacterial keratitis with corneal ulcers was not found to be statistically significant. However, it can be considered as an adjuvant agent in terms of shortening the healing time. There is a need for more extensive series, randomized, prospective clinical trials.
Keywords: Corneal ulcer; keratitis; Coenzyme Q10
ÖZET
Amaç: Bu çalışmada, bakteriyel keratitte Koenzim Q10 (KoQ10) göz damlasının korneal yara iyileşmesi üzerindeki etkinliğini ve güvenilirliğini değerlendirmeği amaçladık. Gereç ve Yöntemler: Bakteriyel keratit tanısıyla yatırılarak tedavisi yapılan hastalar çalışmaya alındı. Hastaların yaşı, cinsiyeti ve hangi gözün tutulduğu kaydedildi. Hastalara tam bir göz muayenesi yapıldı ve hipopiyon olup olmadığı kaydedildi. Korneal ülser büyüklüğü yatay ve dikey olarak ölçüldü. Hastalar rastgele 2 gruba ayrıldı. Her iki gruba da topikal antibiyotik ve siklopentolat damla verildi. Birinci gruba ek olarak KoQ10 göz damlası 4×1 tedaviye eklendi. Tedavi öncesi ve tedaviye başlandıktan sonra ülser iyileşene kadar günlük olarak korneal ülser görüntüleri alındı ve kaydedildi. Bulgular: Çalışmaya alınan toplam 32 hastanın yaş ortalaması 51,16±25,31 (7-90) yıl olup, 20'si (%62,5) erkek, 12'si (%37,5) kadın idi. KoQ10 göz damlası verilen grup (n=16) ile kontrol grubunun (n=16) yaş, cinsiyet, sağ-sol göz tutulumu, hipopiyon varlığı ve korneal ülser boyutu açısından istatistiksel olarak anlamlı farkı yoktu (p>0,05). Ortalama iyileşme süresi KoQ10 göz damlası verilen grupta 12,25±6,02 gün ve kontrol grubunda 19±12,9 gün idi (p=0,076). Sonuç: KoQ10 göz damlası, bakteriyel keratite bağlı gelişen korneal ülser tedavisindeki etkisi istatistiksel olarak anlamlı bulunamadı. Ancak iyileşme süresinin kısalması açısından adjuvan ajan olarak düşünülebilir. Bu konuda daha geniş serilere sahip randomize, prospektif klinik çalışmalara ihtiyaç vardır.
Anahtar Kelimeler: Korneal ülser; keratit; Koenzim Q10
Amaç: Bu çalışmada, bakteriyel keratitte Koenzim Q10 (KoQ10) göz damlasının korneal yara iyileşmesi üzerindeki etkinliğini ve güvenilirliğini değerlendirmeği amaçladık. Gereç ve Yöntemler: Bakteriyel keratit tanısıyla yatırılarak tedavisi yapılan hastalar çalışmaya alındı. Hastaların yaşı, cinsiyeti ve hangi gözün tutulduğu kaydedildi. Hastalara tam bir göz muayenesi yapıldı ve hipopiyon olup olmadığı kaydedildi. Korneal ülser büyüklüğü yatay ve dikey olarak ölçüldü. Hastalar rastgele 2 gruba ayrıldı. Her iki gruba da topikal antibiyotik ve siklopentolat damla verildi. Birinci gruba ek olarak KoQ10 göz damlası 4×1 tedaviye eklendi. Tedavi öncesi ve tedaviye başlandıktan sonra ülser iyileşene kadar günlük olarak korneal ülser görüntüleri alındı ve kaydedildi. Bulgular: Çalışmaya alınan toplam 32 hastanın yaş ortalaması 51,16±25,31 (7-90) yıl olup, 20'si (%62,5) erkek, 12'si (%37,5) kadın idi. KoQ10 göz damlası verilen grup (n=16) ile kontrol grubunun (n=16) yaş, cinsiyet, sağ-sol göz tutulumu, hipopiyon varlığı ve korneal ülser boyutu açısından istatistiksel olarak anlamlı farkı yoktu (p>0,05). Ortalama iyileşme süresi KoQ10 göz damlası verilen grupta 12,25±6,02 gün ve kontrol grubunda 19±12,9 gün idi (p=0,076). Sonuç: KoQ10 göz damlası, bakteriyel keratite bağlı gelişen korneal ülser tedavisindeki etkisi istatistiksel olarak anlamlı bulunamadı. Ancak iyileşme süresinin kısalması açısından adjuvan ajan olarak düşünülebilir. Bu konuda daha geniş serilere sahip randomize, prospektif klinik çalışmalara ihtiyaç vardır.
Anahtar Kelimeler: Korneal ülser; keratit; Koenzim Q10
REFERANSLAR:
- Austin A, Lietman T, Rose-Nussbaumer J. Update on the management of infectious keratitis. Ophthalmology. 2017;124(11):1678-89. [Crossref] [PubMed] [PMC]
- Green M, Apel A, Stapleton F. Risk factors and causative organisms in microbial keratitis. Cornea. 2008;27(1):22-7. [Crossref] [PubMed]
- McDonald EM, Ram FS, Patel DV, McGhee CN. Topical antibiotics for the management of bacterial keratitis: an evidence-based review of high quality randomised controlled trials. Br J Ophthalmol. 2014;98(11):1470-7. [Crossref] [PubMed]
- Gumus K. Topical coenzyme Q10 eye drops as an adjuvant treatment in challenging refractory corneal ulcers: a case series and literature review. Eye Contact Lens. 2017;43(2):73-80. [Crossref] [PubMed]
- Choi JS, Joo CK. Wakayama symposium: new therapies for modulation of epithelialization in corneal wound healing. Ocul Surf. 2013;11(1):16-8. [Crossref] [PubMed]
- Lenaz G, Fato R, Castelluccio C, Genova ML, Bovina C, Estornell E, et al. The function of coenzyme Q in mitochondria. Clin Investig. 1993;71(8 Suppl):S66-70. [Crossref] [PubMed]
- Behndig A, Svensson B, Marklund SL, Karlsson K. Superoxide dismutase isoenzymes in the human eye. Invest Ophthalmol Vis Sci. 1998;39(3):471-5. [PubMed]
- Kasetsuwan N, Wu FM, Hsieh F, Sanchez D, McDonnell PJ. Effect of topical ascorbic acid on free radical tissue damage and inflammatory cell influx in the cornea after excimer laser corneal surgery. Arch Ophthalmol. 1999;117(5):649-52. [Crossref] [PubMed]
- Brancato R, Schiavone N, Siano S, Lapucci A, Papucci L, Donnini M, et al. Prevention of corneal keratocyte apoptosis after argon fluoride excimer laser irradiation with the free radical scavenger ubiquinone Q10. Eur J Ophthalmol. 2000;10(1):32-8. [Crossref] [PubMed]
- Brancato R, Fiore T, Papucci L, Schiavone N, Formigli L, Orlandini SZ, et al. Concomitant effect of topical ubiquinone Q10 and vitamin E to prevent keratocyte apoptosis after excimer laser photoablation in rabbits. J Refract Surg. 2002;18(2):135-9. [Crossref] [PubMed]
- Chen CC, Chang JH, Lee JB, Javier J, Azar DT. Human corneal epithelial cell viability and morphology after dilute alcohol exposure. Invest Ophthalmol Vis Sci. 2002;43(8):2593-602. [PubMed]
- Mencucci R, Favuzza E, Boccalini C, Lapucci A, Felici R, Resta F, et al. CoQ10-containing eye drops prevent UVB-induced cornea cell damage and increase cornea wound healing by preserving mitochondrial function. Invest Ophthalmol Vis Sci. 2014;55(11):7266-71. [Crossref] [PubMed]
- Parisi V, Centofanti M, Gandolfi S, Marangoni D, Rossetti L, Tanga L, et al. Effects of coenzyme Q10 in conjunction with vitamin E on retinal-evoked and cortical-evoked responses in patients with open-angle glaucoma. J Glaucoma. 2014;23(6):391-404. [Crossref] [PubMed]
- Lulli M, Witort E, Papucci L, Torre E, Schipani C, Bergamini C, et al. Coenzyme Q10 instilled as eye drops on the cornea reaches the retina and protects retinal layers from apoptosis in a mouse model of kainate-induced retinal damage. Invest Ophthalmol Vis Sci. 2012;53(13):8295-302. [Crossref] [PubMed]
- Chen CC, Liou SW, Chen CC, Chen WC, Hu FR, Wang IJ, et al. Coenzyme Q10 rescues ethanol-induced corneal fibroblast apoptosis through the inhibition of caspase-2 activation. J Biol Chem. 2013;288(17):11689-704. [Crossref] [PubMed] [PMC]
- Sharma N, Goel M, Bansal S, Agarwal P, Titiyal JS, Upadhyaya AD, et al. Evaluation of moxifloxacin 0.5% in treatment of nonperforated bacterial corneal ulcers: a randomized controlled trial. Ophthalmology. 2013;120(6):1173-8. [Crossref] [PubMed]
- Bozkurt Oflaz A, Bozkurt B, Kamış Ü, Ekinci Köktekir B. Corneal collagen crosslinking treatment in a case with pneumococcal keratitis. Turk J Ophthalmol. 2017;47(3):161-4. [Crossref] [PubMed] [PMC]
- Fogagnolo P, Sacchi M, Ceresara G, Paderni R, Lapadula P, Orzalesi N, et al. The effects of topical coenzyme Q10 and vitamin E D-α-tocopheryl polyethylene glycol 1000 succinate after cataract surgery: a clinical and in vivo confocal study. Ophthalmologica. 2013;229(1):26-31. [Crossref] [PubMed]
- Morlet N, Daniell M. Microbial keratitis: what's the preferred initial therapy? View 2: Empirical fluoroquinolone therapy is sufficient initial treatment. Br J Ophthalmol. 2003;87(9):1169-72. [Crossref] [PubMed] [PMC]
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