ABSTRACT
A 65-year-old male presented with decreased vision in the left eye of 15-day duration after having undergone an uneventful cataract surgery 10 months back. He had been previously treated with systemic steroids for recurrent uveitis postoperatively on three occasions in the same eye. B-scan ultrasonography showed multiple clumplike echoes suggestive of vitreous inflammation. Aqueous tap revealed Pseudomonas aeruginosa sensitive to ciprofloxacin. The patient was treated with intravitreal ciprofloxacin and vancomycin along with systemic ciprofloxacin with good clinical response. Even a virulent organism such as P.aeruginosa can present as a chronic uveitis, which, if missed, can lead to a delay in accurate diagnosis and appropriate management.
ABSTRACT
This study was conducted to determine the safe intravitreal dosage of ciprofloxacin. Twenty-four phakic eyes of New Zealand pigmented rabbits were used. Each group(4 eyes) received midvitreal ciprofloxacin of 100, 200, 400, 600, 800 micro gram in 0.1ml BSS Plus, or 0.1ml BSS Plus only as control. We evaluated retinal function by measuring the electroretinograms for a graded series of flash intensities and fitting b-wave amplitudes to the Naka-Rushton equation. At a dose of greater than 600 micro gram, Rmax decreased signifantly and log K increased signifantly. N-value decreased slightly. B-wave amplitude decreased as a toxic response of intravitreal ciprofloxacin in a dose dependent manner, and this response was best detected using lower luminance stimuli. Lower luminance electroretinography revealed a significant decrease in b-wave amplitude in eyes injected with a dose of 400 micro gram or more. We concluded that 200 micro gram will be the safe intravitreal dosage of ciprofloxacin in phakic rabbit eyes.
Subject(s)
Rabbits , Ciprofloxacin , Electroretinography , New Zealand , RetinaldehydeABSTRACT
This study was designed to determine the maximal safe drug concentration of intravitreal ciprofloxacin in phakic rabbit eyes. Twenty-two eyes of New Zealand pigmented rabbits received midvitreal ciprofloxacin of 100, 200, 400, 600 or 800 microgram in BSS Plus, or BSS Plus only. Retinal toxicity was dose-dependent as determined with electroretinography, light microscopy, and transmission electron microscopy. At a dose of greater than 400 microgram, disorganization of the outer segments was a main pathological finding in transmission electron microscopy. We evaluated retinal function by measuring the electroretinograms for a graded series of flash intensities and by fitting electroretinogram b-wave amplitudes to the Naka-Rushton equation. At a dose of greater than 600 microgram, Rmax was significantly decreased and log K was significantly increased. N-value tended to decrease. A decrease of b-wave amplitudes caused by retinal toxicity could be detected very sensitively with lower luminance stimuli. Determination of retinal toxicity with lower luminance electroretinography revealed a significant decrease of b-wave amplitudes at a dose of greater than 400 microgram. We concluded that a safe dose of intravitreal ciprofloxacin in phakic rabbit eyes was 200 microgram in phakic eyes.