ISSN 1308-8734 | E-ISSN 1308-8742
Original Article
Intravitreal Infliximab Injection to Treat Experimental Endophthalmitis
1 Department of Ophthalmology, Atatürk University School of Medicine, Erzurum, Turkey  
2 Department of Ophthalmology, Iğdır State Hospital, Iğdır, Turkey  
3 Department of Histology and Embryology, Kafkas University School of Medicine, Kars, Turkey  
4 Department of Microbiology, Kafkas University School of Medicine, Kars, Turkey  
5 Department of Microbiology, Atatürk Unversity School of Medicine, Erzurum, Turkey  
6 Department of Ophthalmology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey  
7 Department of Anesthesia and Resuscitation, Erzurum Regional Training and Research Hospital, Erzurum, Turkey  
8 Department of Anesthesia and Resuscitation, Palandöken State Hospital, Erzurum, Turkey  
Eurasian J Med ; : -
DOI: 10.5152/eurasianjmed.2017.17126
Key Words: Infliximab, dexamethasone, vancomycin, staphylococcus epidermidis, endophthalmitis
Abstract

Objective: The purpose of this study was to compare the use of an intravitreal injection of infliximab and of dexamethasone combined with vancomycin to treat experimental endophthalmitis induced by Staphylococcus epidermidis.

 

Materials and Methods: The study was conducted between March 25 and April 13, 2012. Twenty-five six-month-old healthy rabbits were used, each weighing 2.5-3 kg. The rabbits were randomized into five groups with five animals per group. Endophthalmitis was induced by 0.1 mL (103 colony-forming units) S. epidermidis in all groups. In group 1, injection was not implemented after the occurrence of endophthalmitis. In groups 2, 3, and 4, the following intravitreal injections were given 24 h after the occurrence of endophthalmitis: group 2, 0.1 mg/0.1 mL vancomycin; group 3, 1 mg/0.1 mL vancomycin and 1 mg/0.1 mL dexamethasone; and group 4, 1 mg/0.1 mL vancomycin and 2 mg/0.1 mL infliximab. Group 5 was the control/uninfected group. The rabbits were clinically assessed each day for seven days. On day 9, a histopathologic evaluation was performed after enucleation.

 

Results: After a clinical evaluation, no statistically significant difference was found between the vancomycin+infliximab and vancomycin+dexamethasone groups (p>0.05). The difference was significant when both groups were compared with the vancomycin group (p<0.001). After the histopathologic evaluation, no statistically significant difference was found among the three groups (p>0.05).

 

Conclusion: An intravitreal injection of infliximab and of dexamethasone combined with vancomycin have similar clinical and histopathologic effects. To supplement the antibiotic treatment of endophthalmitis, infliximab in a safe dose range can be used as an alternative to dexamethasone to suppress inflammation and prevent ocular damage. 

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