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Intravitreal injection of povidone-iodine for the treatment of vancomycin-resistant Enterococcus faecalis endophthalmitis in rabbit eyes.

Abstract
The aim of this study was to investigate the efficacy of intravitreal povidone-iodine (PI) in the treatment of vancomycin-resistant Enterococcus faecalis (VRE) endophthalmitis. Fifty New Zealand white rabbits were divided into 5 groups (n = 10 in each group). After the induction of endophthalmitis using VRE (minimum inhibitory concentration [MIC] ≥ 40 μg/mL) in the right eye, Group A, B, C, and D received intravitreal injections of 0.1% PI, 0.3% PI, 0.05% vancomycin, and 0.5% vancomycin, respectively. Eyes in Group E were used as controls. Fundus photography, vitreous culture, electroretinography (ERG), and histologic examinations of the retina were conducted on day 14. A marked improvement in endophthalmitis was observed in Group A, B, C and D, compared to Group E. Fundus photographs showed mild vitreous opacities in Group A and B, and moderate vitreous opacity in Group C. All eyes in Group D had a clear vitreous. In vitreous culture, bacterial growth was found in 6 eyes (100, 200, 200, 400, 500, and 500 colony-forming units) in Group C, but not in Groups A, B, or D. ERG and histological examination also indicated intraocular damage in Group C. Our results show that intravitreal injection of PI, even at low concentrations, was effective for treatment of VRE endophthalmitis, although some vitreous opacity remained. Intravitreal vancomycin injection was also useful to treat resistant strains, if used at a higher concentration within the safety threshold.
AuthorsSeung Min Lee, Jong Ho Park, Chul Hun Jang, Iksoo Byon
JournalExperimental eye research (Exp Eye Res) Vol. 208 Pg. 108614 (07 2021) ISSN: 1096-0007 [Electronic] England
PMID33971221 (Publication Type: Journal Article)
CopyrightCopyright © 2021 Elsevier Ltd. All rights reserved.
Chemical References
  • Anti-Infective Agents, Local
  • Povidone-Iodine
Topics
  • Animals
  • Anti-Infective Agents, Local (administration & dosage)
  • Colony Count, Microbial
  • Disease Models, Animal
  • Electroretinography
  • Endophthalmitis (drug therapy, microbiology, pathology)
  • Enterococcus faecalis (isolation & purification)
  • Eye Infections, Bacterial (drug therapy, microbiology, pathology)
  • Gram-Positive Bacterial Infections (drug therapy, microbiology, pathology)
  • Intravitreal Injections
  • Povidone-Iodine (administration & dosage)
  • Rabbits
  • Retina (pathology)
  • Vancomycin Resistance
  • Vitreous Body (microbiology, pathology)

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