COMPARATIVE TREATMENT OF BACTERIAL ENDOPHTHALMITIS

本研究的目的是建立一种标准化的动物模型， 革兰氏阳性球菌致兔细菌性眼内炎 典型地产生轻度疾病（表皮葡萄球菌）， 典型地产生中度临床疾病的阳性球菌 （金黄色葡萄球菌），和Ram阴性杆菌，其通常产生 压倒性感染（绿脓杆菌）。 的进一步目标 这项研究是利用这个标准化模型来确定最安全的 最有效的治疗方案。 静脉抗生素、眼内抗生素、睫状体平坦部玻璃体切除术和 口服类固醇将在治疗组合中进行测试， 临床实践 将首先进行研究，以证明最大 通过静脉给药在发炎的眼睛中产生的玻璃体水平 抗生素。 抗生素治疗水平的耐药性 眼内注射后的玻璃体切除术后发炎的眼睛也将 测定了 接种活菌和热灭活菌的时间 进入玻璃体的不同浓度将 可以变化以模拟临床环境。 疗效比较 将根据临床体征的定量量表，由 设盲观察者，并通过t检验评估统计学显著性。 配对、并行对照动物或同一动物的对侧眼 将作为对照。 我们会仔细留意 在任何实验注射中活细菌与死细菌的定量。 临床结局分析将通过以下评价来加强： 视网膜电图反应，终末玻璃体培养，和 通过光镜和超微结构显微镜进行组织病理学评价。

The objective of this study is to establish a standardized animal model of bacterial endophthalmitis in the rabbit utilizing a gram positive coccus typically producing a mild disease (Staphylococcus epidermidis), a gram positive coccus typically producing a moderate clinical disease (Staphylococcus aureus), and a Ram negative rod which usually produces an overwhelming infection (Pseudomonas aeruginosa). The further objective of this study is to exploit this standardized model to determine the safest and most effective treatment regimen for the management of the disease. Intravenous antibiotics, intraocular antibiotics, pars plana vitrectomy and oral steroids will be tested in therapeutic combinations which mimic clinical practice. Studies will first be performed to demonstrate maximum vitreous levels produced in the inflamed eye by intravenous administration of antibiotic. Resistance of therapeutic levels of antibiotic in vitrectomized inflamed eyes after intraocular injection will also be measured. Time from inoculation of viable and heat-killed organisms at varying concentrations into the vitreous to the institution of therapy will be varied to simulate clinical settings. Comparison of therapeutic effects will be made on the basis of a quantitative scale for clinical signs by a masked observer, and evaluated for statistical significance by the t-test. Paired, concurrent control animals or the fellow eye of the same animal will serve as controls. Careful attention will be paid to the quantification of live vs dead bacteria in any experimental injection. Clinical outcome analysis will be augmented by evaluation of electroretinographic response, terminal vitreous cultures, and histopathologic evaluation by light and ultrastructural microscopy.