ABSTRACT
Careful examination of external and internal ocular structures in patients with systemic infections may assist in early diagnosis and institution of appropriate therapy. Recent literature discussing ocular manifestations in the following systemic infectious diseases are reviewed: tuberculosis, Lyme borreliosis, cat scratch disease, toxocariasis, congenital toxoplasmosis, and invasive aspergillosis.
Subject(s)
Eye Infections/etiology , Animals , Eye Infections/pathology , Eye Infections/therapy , HumansABSTRACT
The overall importance of the peak or the mean serum concentrations as predictors of ocular drug penetration is unknown. To address this fundamental question with an agent which shows promise as adjunctive therapy in the treatment of endophthalmitis, we studied the penetration of ciprofloxacin into the aqueous and vitreous humors following three different modes of systemic administration. New Zealand white rabbits received either a single bolus dose (40 mg kg-1), three intermittent doses of 13.33 mg kg-1 evenly spaced over an 8 hr period, or a continuous infusion of 40 mg kg-1 over an 8 hr period. Pharmacokinetic analysis was performed using RSTRIP II, a non-linear, least square regression model analysis program. The serum area under the concentration-time curve (AUC) values for each mode of drug administration were similar: 32.9 micrograms hr ml-1 for single dose, 31.9 micrograms hr ml-1 for intermittent dose, and 33.8 micrograms hr ml-1 for continuous infusion modes. The percentage penetration into the aqueous and vitreous were also similar; 30.5% and 6.5% for a single dose, 31.6% and 7.4% for intermittent doses and 30.0% and 7.5% for continuous infusion. The penetration into the aqueous and vitreous humors was not influenced by mode of administration. As with other quinolones we have studied, elimination rates were similar for the central and peripheral compartments in the post-distributive phase. Vitreous humor ciprofloxacin concentrations achieved were below that which inhibits most Staphylococcus epidermidis, the most common isolate in patients with post-operative endophthalmitis.
Subject(s)
Anti-Infective Agents/pharmacokinetics , Aqueous Humor/metabolism , Ciprofloxacin/pharmacokinetics , Vitreous Body/metabolism , Animals , Anti-Infective Agents/administration & dosage , Anti-Infective Agents/blood , Biological Assay , Chromatography, High Pressure Liquid , Ciprofloxacin/administration & dosage , Ciprofloxacin/blood , Computers , Drug Administration Schedule , Male , Models, Biological , Perfusion , Rabbits , Regression AnalysisABSTRACT
Patients with various systemic infections can often be diagnosed on the basis of their presenting ocular signs and symptoms. Recognition of the ocular manifestations of systemic infections will expedite diagnosis and allow rapid institution of appropriate therapy thereby reducing morbidity and mortality. Recent literature discussing ophthalmologic findings in the following diseases are reviewed: Whipple's disease, endogenous endophthalmitis, cat-scratch disease, toxoplasmosis, and hepatitis C.
