Effects of intravitreal corticosteroid in the treatment of Staphylococcus aureus-induced experimental endophthalmitis.
OBJECTIVE
To investigate whether intravitreal injection of dexamethasone in addition to antibiotics can minimize intraocular tissue injury caused by Staphylococcus aureus endophthalmitis.


METHODS
Albino rabbits were infected with an intravitreal injection of 1000 colony-forming units of S. aureus. The rabbits were randomized to receive no treatment (control group; n = 2), intravitreal vancomycin and amikacin (n = 5), or a combination of intravitreal vancomycin, amikacin, and dexamethasone (n = 5) 20 hours following inoculation of bacteria. All rabbits except for the control group also received intravenous imipenem every 8 hours for 4 days. The eyes were evaluated by clinical examination, electroretinogram (ERG), and histologic studies.


RESULTS
Eyes treated with intravitreal dexamethasone demonstrated less inflammation on clinical examination compared with eyes that received antibiotics alone. The ERG responses of eyes that received both intravitreal antibiotics and steroid were significantly better at 45 hours, 7 and 14 days following inoculation (P < 0.05) compared to eyes that received antibiotics alone. Histologic studies 14 days following infection demonstrated less tissue destruction for eyes treated with dexamethasone.


CONCLUSIONS
Compared to intravitreal antibiotics alone, intravitreal corticosteroids may improve visual outcome of S. aureus endophthalmitis by reducing inflammation and preserving electrophysiologic retinal function.
De Kaspar
Herminia Miño
HM
Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Ta
Christopher N
CN
Engelbert
Michael
M
Mette
Martina
M
Thiel
Martin
M
Kampik
Anselm
A
D000583:Amikacin / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D004596:Electroretinography; D009877:Endophthalmitis / Q000188:drug therapy* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D015378:Imipenem / Q000627:therapeutic use; D007267:Injections; D011817:Rabbits; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000502:physiology*; D014640:Vancomycin / Q000627:therapeutic use; D014822:Vitreous Body
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D014640:Vancomycin; D015378:Imipenem; D003907:Dexamethasone; D000583:Amikacin