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October 1995

Effect of Intravitreal Dexamethasone in Treatment of Pneumococcal Endophthalmitis in Rabbits

Author Affiliations

From the Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas (Dr Park); Retina Service (Drs Park, Samiy, and D'Amico) and Infectious Disease Service (Dr Baker), Massachusetts Eye and Ear Infirmary, Boston; Departments of Ophthalmology (Drs Park, Samiy, and D'Amico), Medicine (Dr Baker), and Microbiology and Molecular Genetics (Dr Ruoff), Harvard Medical School, Boston; and Clinical Microbiology Laboratory, Massachusetts General Hospital, Boston (Dr Ruoff).

Arch Ophthalmol. 1995;113(10):1324-1329. doi:10.1001/archopht.1995.01100100112040

Purpose:  To investigate whether corticosteroid therapy would decrease the inflammation and tissue damage associated with pneumococcal endophthalmitis.

Methods:  Albino rabbits were injected intravitreally with 1000 live organisms of Streptococcus pneumoniae and randomized after 24 hours to treatment with intravitreal vancomycin hydrochloride alone (n=10), combination intravitreal vancomycin and intravitreal dexamethasone (n=10), or no treatment (n=10). After 2 weeks, the eyes were examined clinically and enucleated for histopathologic examination.

Results:  Eyes treated with vancomycin and dexamethasone had significantly less intraocular inflammation and more preservation of retinal tissue than untreated eyes or eyes treated with vancomycin alone (P<.05, Fisher's exact test). Untreated and vancomycin-treated eyes were indistinguishable on clinical and histologic examination. Marked anterior and posterior segment inflammation with total retinal necrosis was noted in eyes from both groups.

Conclusion:  Intravitreal corticosteroid therapy may play an important role in minimizing the inflammation and tissue damage associated with pneumococcal endophthalmitis.