Intravitreal dexamethasone in exogenous bacterial endophthalmitis: results of a prospective randomised study.

Abstract

AIM:

To evaluate the efficacy of intravitreal dexamethasone co-administered with intravitreal antibiotics along with vitrectomy in the management of exogenous bacterial endophthalmitis.

METHODS:

In a prospective randomised clinical trial, 63 patients (63 eyes) with suspected bacterial endophthalmitis (postoperative and post-traumatic) were treated with vitrectomy and intravitreal antibiotics and randomised to intravitreal dexamethasone (IOAB with = 29 eyes) and no dexamethasone (IOAB without = 34 eyes). Inflammation score (IS) and visual acuity were measured by two masked observers before surgery, and at 1, 4, and 12 weeks after surgery in both the groups.

RESULTS:

There was significant reduction (p <0.0001) in IS at 1, 4, and 12 weeks after the surgery in the "IOAB with" group; there was temporary but significant increase (p <0.01) in IS at 1 week in the "IOAB without" group, before decline (p <0.001) of IS at 4 and 12 weeks. The magnitude and relative percentage change in IS between the two groups were found to be significant at 1 (p <0.0001), and 4 (p <0.01) weeks, and not at 12 weeks. The visual acuity at 12 weeks was comparable in both the IOAB with and IOAB without groups.

CONCLUSION:

Intravitreal dexamethasone helps in early reduction of inflammation in exogenous bacterial endophthalmitis, but has no independent influence on the visual outcome. In selected patients with endophthalmitis where oral corticosteroids cannot be given for medical reasons intravitreal corticosteroids could be beneficial; in other situations they could be complementary to oral corticosteroid therapy.

• Authors: T Das, S Jalali, V K Gothwal, S Sharma, T J Naduvilath
• Journal: The British journal of ophthalmology (Br J Ophthalmol) Vol. 83 Issue 9 Pg. 1050-5 (Sep 1999) ISSN: 0007-1161 [Print] England
• PMID: 10460774 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Anti-Inflammatory Agents
• Glucocorticoids
• Dexamethasone

Topics

• Administration, Topical
• Aged
• Aged, 80 and over
• Algorithms
• Anti-Bacterial Agents
• Anti-Inflammatory Agents (administration & dosage)
• Dexamethasone (administration & dosage)
• Drug Therapy, Combination (therapeutic use)
• Endophthalmitis (drug therapy, microbiology, surgery)
• Eye Infections, Bacterial (drug therapy, surgery)
• Female
• Glucocorticoids
• Humans
• Male
• Middle Aged
• Postoperative Care (methods)
• Prospective Studies
• Treatment Outcome