Epidemiology of infective endophthalmitis in France. The French Collaborative Study Group on Endophthalmitis.

Data from retrospective studies of endophthalmitis vary widely with respect to incidence and to the pathogens implicated. To see whether we could provide more accurate data, we have done a prospective multicentre national survey of endophthalmitis over one year in France. Records of 36,241 operations and 1148 cases of ocular trauma from 64 centres specialising in eye surgery were analysed. There were 167 cases of endophthalmitis; incidence of postoperative endophthalmitis was 0.31 per 100 operations, and the risk after penetrating ocular trauma was 2.8%. In contrast with most previous studies, Staphylococcus epidermidis was the most frequently isolated organism, with gram-negative organisms accounting for only a small proportion of cases. Patients infected with streptococci had the least favourable outcome. The survey confirms data from retrospective studies showing that the incidence of postoperative or post-injury endophthalmitis is low. The low frequency means that large numbers of patients would be required for a trial of antibiotic efficacy, but such a trial is worthwhile because there are now antibiotics with good ocular bioavailability that are effective against most of the bacteria that cause endophthalmitis.

[Diffusion of fluoroquinolones in the aqueous humor and crystalline lens]. / Diffusion des fluoroquinolones dans l'humeur aqueuse et le cristallin.

In 53 patients undergoing cataract extraction, the authors measured pefloxacin and ofloxacin penetration in aqueous humour and lens. Cataract removal was performed at varying times after either the end of one-hour infusion of pefloxacin, ofloxacin per os in one time, or pefloxacin per os during 3 days. In the two first schemes, acme concentrations in aqueous humour are 1.45 mg/l for pefloxacin, 1.14 mg/l for ofloxacin. These concentrations reach the MIC90 of most bacteria usually involved in endophthalmia. The steady state concentrations of pefloxacin are between 6 and 7 mg/l during the first 12 h: they reach the MIC of 80% of Streptococci. There is no evidence of accumulation of pefloxacin in lens; lenticular concentrations of ofloxacin are very low and rapidly decrease.

Pharmacokinetics of aztreonam in the aqueous humour.

Fifteen patients awaiting cataract extraction were given a 2 g intravenous bolus injection of aztreonam. The mean aztreonam concentrations in the aqueous humour. 1, 2 and 4 h after the injection were 1.22, 1.46 and 2.22 mg/l, respectively.

Pefloxacin concentrations in human aqueous humour and lens.

In 20 patients undergoing cataract extraction, we measured pefloxacin concentrations in the eye. After a 1 h infusion of pefloxacin 400 mg iv, the mean pefloxacin concentrations 2, 6, 12 and 24 h post-infusion were 0.75, 1.45, 1.04 and 0.86 mg/l, respectively. The simultaneous mean pefloxacin concentrations in the lens were 0.09, 0.20, 0.26 and 0.43 mg/l, respectively. The adequate penetration of pefloxacin into uninfected aqueous humour and lens suggests that this antibiotic may be effective in the treatment of certain bacterial endophthalmic infections.

[A case of cavernous hemangioma of the retina]. / Un cas d'hémangiome caverneux de la rétine.

A case of hemangioma of the retina is reported. Its typical ophtalmoscopic and fluorescein angiographic aspects are studied. The benign evolution is stressed in spite of a possible macular risk checked by argon laser therapy.