Yoshizumi M O, Kashani A, Palmer J, Lee G, Mondino B
Jules Stein Eye Institute, UCLA School of Medicine, Department of Ophthalmology, Los Angeles, California 90095-7000, USA.
J Ocul Pharmacol Ther. 1999 Feb;15(1):91-6. doi: 10.1089/jop.1999.15.91.
We attempted to determine whether treatment using intramuscular methylprednisolone plus intravitreal vancomycin decreased ocular inflammation and preserved retinal function better in experimental Staphylococcus aureus (S. aureus) endophthalmitis than treatment with intravitreal vancomycin alone. Sixteen rabbits received intravitreal inoculations in both eyes with S. aureus and the rabbits were divided into two groups (group I and group II) of eight rabbits each. Group I rabbits were treated with one injection of intravitreal vancomycin in each eye at either 24, 36, 48 or 72 hours after bacterial inoculation followed by seven consecutive days of high dose intramuscular methylprednisolone (30 mg/kg per day). Group II rabbits were treated with only one intravitreal injection of vancomycin in each eye at equivalent time intervals as in Group I. Clinical evaluations of ocular inflammation were performed by slit-lamp biomicroscopy and indirect ophthalmoscopy. Electroretinography (ERG) was performed eight days after bacterial inoculation to assess retinal function in all eyes. The combination of intramuscular methylprednisolone and intravitreal vancomycin resulted in a degree of ocular inflammation equal to eyes treated with intravitreal vancomycin alone at all treatment intervals. ERG responses were not significantly different in either group. A single intravitreal injection of vancomycin plus daily intramuscular methylprednisolone for seven days were found neither to decrease ocular inflammation nor preserve retinal function better than a single intravitreal injection of vancomycin in our experimental model of S. aureus endophthalmitis.
我们试图确定，在实验性金黄色葡萄球菌性眼内炎中，与单纯玻璃体内注射万古霉素相比，肌肉注射甲泼尼龙联合玻璃体内注射万古霉素治疗是否能更好地减轻眼部炎症并保留视网膜功能。16只兔子双眼均接受了金黄色葡萄球菌玻璃体内接种，并被分为两组（I组和II组），每组8只兔子。I组兔子在细菌接种后24、36、48或72小时时，每只眼睛接受一次玻璃体内注射万古霉素，随后连续7天肌肉注射高剂量甲泼尼龙（每天30mg/kg）。II组兔子在与I组相同的等效时间间隔，每只眼睛仅接受一次玻璃体内注射万古霉素。通过裂隙灯生物显微镜检查和间接检眼镜检查对眼部炎症进行临床评估。在细菌接种8天后进行视网膜电图（ERG）检查，以评估所有眼睛的视网膜功能。在所有治疗间隔中，肌肉注射甲泼尼龙和玻璃体内注射万古霉素联合治疗导致的眼部炎症程度与仅接受玻璃体内注射万古霉素治疗的眼睛相当。两组的ERG反应均无显著差异。在我们的金黄色葡萄球菌性眼内炎实验模型中，发现单次玻璃体内注射万古霉素加7天每日肌肉注射甲泼尼龙，在减轻眼部炎症或保留视网膜功能方面，并不比单次玻璃体内注射万古霉素更好。
