title: Evaluation of Antifungal Efficacy of 0.1% and 0.25% Riboflavin with UVA: A Comparative In Vitro Study.
abstract: Antifungal efficacy of photochemical cross-linking (PACK-CXL) with 0.1% and 0.25% riboflavin was evaluated with a comparative in vitro study.
  
  
  
  Candida albicans and Aspergillus fumigatus ATCC reference strains, Candida parapsilosis, Aspergillus fumigatus, Fusarium solani, Scedosporium apiospermum, and Alternaria alternata strains isolated from keratitis cases were chosen as targeted microorganisms. Unique "black plate method" was developed in polystyrene microplates. Riboflavin suspensions in 0.1% and 0.25% were separately added into inoculated wells. Non-inoculated wells were filled by black colored dye in order to protect treated wells from reflection of UV treatment. After ultraviolet A (UVA) treatment, each well was evaluated by microbiological culture in order to count viable fungal colonies. Fungal killing rate was calculated by comparing fungal counts (CFU/mL) before and after UVA application of riboflavin-added wells.
  
  
  
  Four different fungal inoculum concentrations of targeted microorganisms, including 104, 103, 102, and 101CFU/mL, were assayed. PACK-CXL with 0.25% riboflavin was found to be highly effective on fungal cells even in 104CFU/mL of concentration.
  
  
  
  PACK-CXL appears as a promising treatment option for difficult-to-treat cases of fungal keratitis and 0.25% riboflavin concentration increases fungicidal effect of the procedure dramatically.
authors.affiliation: a Department of Opthalmology , School of Medicine, Gazi University , Ankara , Turkey.
authors.forename: Kamil
authors.initials: K
authors.lastname: Bilgihan
authors.affiliation: b Department of Medical Microbiology , School of Medicine, Gazi University , Ankara , Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Kalkanci
authors.affiliation: a Department of Opthalmology , School of Medicine, Gazi University , Ankara , Turkey.
authors.forename: Huseyin Baran
authors.initials: HB
authors.lastname: Ozdemir
authors.affiliation: b Department of Medical Microbiology , School of Medicine, Gazi University , Ankara , Turkey.
authors.forename: Reyhan
authors.initials: R
authors.lastname: Yazar
authors.affiliation: b Department of Medical Microbiology , School of Medicine, Gazi University , Ankara , Turkey.
authors.forename: Funda
authors.initials: F
authors.lastname: Karakurt
authors.affiliation: a Department of Opthalmology , School of Medicine, Gazi University , Ankara , Turkey.
authors.forename: Erdem
authors.initials: E
authors.lastname: Yuksel
authors.affiliation: c Department of Medical Microbiology , School of Medicine, Mersin University , Mersin , Turkey.
authors.forename: Feza
authors.initials: F
authors.lastname: Otag
authors.affiliation: d Mycology Reference Laboratory, Public Health Institution of Turkey , Ankara , Turkey.
authors.forename: Nilgun
authors.initials: N
authors.lastname: Karabicak
authors.affiliation: e Department of Medical Microbiology , School of Medicine, Hacettepe University , Ankara , Turkey.
authors.forename: Sevtap
authors.initials: S
authors.lastname: Arikan-Akdagli
mesh_terms: D003094:Collagen / Q000494:pharmacology; D015169:Colony Count, Microbial; D003432:Cross-Linking Reagents / Q000494:pharmacology; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000382:microbiology; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007634:Keratitis / Q000188:drug therapy* / Q000382:microbiology; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000494:pharmacology; D012256:Riboflavin / Q000494:pharmacology*; D014466:Ultraviolet Rays
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin
keywords: 0.1% and 0.25% riboflavin; antifungal efficacy; black plate method; photochemical cross-linking (PACK-CXL)