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Susanna S. Park, MD, PhD; Nasrollah Samiy, MD; Kate Ruoff, PhD; Donald J. D'Amico, MD; Ann Sullivan Baker, MD

Arch Ophthalmol. 1995;113(10):1324-1329.

Abstract
Purpose
To investigate whether corticosteroid therapy would decrease the inflammation and tissue damage associated with pneumococcal endophthalmitis.

Methods
Albino rabbits were injected intravitreally with 1000 live organisms of Streptococcus pneumoniae and randomized after 24 hours to treatment with intravitreal vancomycin hydrochloride alone (n=10), combination intravitreal vancomycin and intravitreal dexamethasone (n=10), or no treatment (n=10). After 2 weeks, the eyes were examined clinically and enucleated for histopathologic examination.

Results
Eyes treated with vancomycin and dexamethasone had significantly less intraocular inflammation and more preservation of retinal tissue than untreated eyes or eyes treated with vancomycin alone (P<.05, Fisher's exact test). Untreated and vancomycin-treated eyes were indistinguishable on clinical and histologic examination. Marked anterior and posterior segment inflammation with total retinal necrosis was noted in eyes from both groups.

Conclusion
Intravitreal corticosteroid therapy may play an important role in minimizing the inflammation and tissue damage associated with pneumococcal endophthalmitis.

Author Affiliations
From the Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas (Dr Park); Retina Service (Drs Park, Samiy, and D'Amico) and Infectious Disease Service (Dr Baker), Massachusetts Eye and Ear Infirmary, Boston; Departments of Ophthalmology (Drs Park, Samiy, and D'Amico), Medicine (Dr Baker), and Microbiology and Molecular Genetics (Dr Ruoff), Harvard Medical School, Boston; and Clinical Microbiology Laboratory, Massachusetts General Hospital, Boston (Dr Ruoff).

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