J Korean Ophthalmol Soc.  1993 Dec;34(12):1234-1241.

Retinal Toxicity of Vancomycin in Vitreous Replacement Fluid

• Jung WS
• Oum BS

Abstract

Vancomycin is an anti biotic produced by Streptomyces orientalis and is primarily active against gram-positive bacteria, especially against methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis. It has been increasingly recommended for intravitreal injection on behalf of conventional therapy in bacterial endophthalmitis caused by gram-positive organisms due to increasing resistance to the cefazolin. Authors evaluated the retinal toxic reaction after vitrectomy with infravitreal infusion containing various doses of vancomycin between 1 microgram/ml to 500 microgram/ml into 20 rabbit eyes to determine the safe dose of vancomycin. The histologic features of the rabbit eyes treated with 20 microgram/ml or more showed toxic reactions including hypertrophy of retinal pigment epithelium, disorganization and loss of the photoreceptor cells and accummulation of inflammatory cells in subretinal space. These results suggest that intravitreal infuion of vancomycin in a dose of 10 microgram/ml or less appears to have no retinal toxicity in the rabbit model.

Keyword

Bacterial endophthalmitis; Intravitreal infusion; Retinal toxicity; Vancomycin

MeSH Terms

Cefazolin
Endophthalmitis
Gram-Positive Bacteria
Hypertrophy
Intravitreal Injections
Methicillin-Resistant Staphylococcus aureus
Photoreceptor Cells
Retinal Pigment Epithelium
Retinaldehyde*
Staphylococcus epidermidis
Streptomyces
Vancomycin*
Vitrectomy
Cefazolin
Retinaldehyde
Vancomycin