Liu K R, Peyman G A, Khoobehi B
LSU Eye Center, Louisiana State University Medical Center School of Medicine, New Orleans.
Invest Ophthalmol Vis Sci. 1989 Jul;30(7):1527-34.
The efficacy of intravitreally administered amphotericin B was evaluated. Experimental fungal infections were produced by inoculation of Candida albicans organisms into the vitreous cavities of 46 rabbit eyes. After 72 hr, eight eyes received intravitreal injections of 10 micrograms of free amphotericin B; and ten eyes each received 10 micrograms, 20 micrograms, and 40 micrograms of liposome-bound amphotericin B. The remaining eight eyes served as controls: four eyes received dextrose solution and four eyes received empty liposomes. Histopathologic examination 8 weeks after inoculation showed clear vitreous without retinal damage in groups treated with either 10 micrograms free amphotericin B or 20 micrograms of liposome-bound drug. All eyes in the control group and six eyes (60%) in the group treated with 10 micrograms of liposome-bound amphotericin B developed vitreous abscesses with evidence of fungal infection. In eyes treated with 40 micrograms of liposome-bound amphotericin B, fungal infection was successfully eradicated, but retinal damage was detected in all eyes by light microscopy. It is proposed that a reduced toxicity of intravitreally injected liposome-bound drugs is accompanied by reduced efficacy. In the treatment of fungal endophthalmitis, an increased dosage of liposome-bound amphotericin B (above that dosage of free drug which would be required) is suggested.
对玻璃体内注射两性霉素B的疗效进行了评估。通过将白色念珠菌接种到46只兔眼的玻璃体腔中制造实验性真菌感染。72小时后，8只眼睛接受了10微克游离两性霉素B的玻璃体内注射；10只眼睛分别接受了10微克、20微克和40微克脂质体结合的两性霉素B。其余8只眼睛作为对照：4只眼睛接受葡萄糖溶液，4只眼睛接受空脂质体。接种8周后的组织病理学检查显示，用10微克游离两性霉素B或20微克脂质体结合药物治疗的组中玻璃体清晰，视网膜无损伤。对照组的所有眼睛以及用10微克脂质体结合两性霉素B治疗的组中的6只眼睛（60%）出现了玻璃体脓肿并有真菌感染的迹象。在用40微克脂质体结合两性霉素B治疗的眼睛中，真菌感染被成功根除，但通过光学显微镜在所有眼睛中均检测到视网膜损伤。有人提出，玻璃体内注射脂质体结合药物的毒性降低伴随着疗效降低。在真菌性眼内炎的治疗中，建议增加脂质体结合两性霉素B的剂量（高于所需游离药物的剂量）。
