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 通常会产生一种轻微的疾病(表皮葡萄球菌)，一克 典型的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，通常会产生 压倒性感染(铜绿假单胞菌)。的进一步目标是 这项研究旨在利用这种标准化模型来确定最安全的 以及对疾病管理最有效的治疗方案。 静脉注射抗生素，眼内抗生素，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，模拟 临床实践。将首先进行研究，以证明最大 静脉给药在发炎眼内产生的玻璃体水平 抗生素。抗菌药物治疗水平的耐药性分析 玻璃体切除后眼内注射发炎的眼睛也会 量过了。从接种活的和热致死的生物开始的时间 将不同浓度的药物注入玻璃体进行治疗 变化以模拟临床环境。两种药物的疗效比较 将根据临床体征的量化标准由 戴面罩的观察者，并用t检验评估其统计学意义。 配对的，同时控制的动物或同一动物的同类眼睛 将作为控制。我们将认真关注 对任何实验注射中的活细菌和死亡细菌进行量化。 临床结果分析将通过评估 视网膜电反应、玻璃体终末培养和 光镜和超微结构观察组织病理学变化。

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.