Effect of Dexamethasone on Experimental Candida Endophthalmitis

Kim, In Taek; Kim, Hong Kyun; Lim, Jung Hun

Abstract

The use of intravitreal corticosteroids in the management of endophthalmitis remains controversial. This study was performed to evaluate the effectiveness of dexamethasone(DXM) in Candida endophthalmitis. In rabbits, Candida albicans(3,000 blastospore: Group A, 30,000 blastopore: Group B) was inoculated intrabitreally. At 24, 48, and 72 hours postinoculation, single intravitreal dose of amphotericin B(AMP, 5microgram/0.1ml) with DXM(400microgram/0.1ml) or AMP alone was given. Clinical examination, protein analysis, electrophysiological and histopathologic measures were utilized to rate DXM effectiveness. Dosage of 5microgram AMP resulted in no culture in both Group A and B, On examinations including the electrophysiologic and histopathologic studies, eyes treated with AMP and DXM did not differ from eyes treated with AMP alone in the Group A(p>0.05). On protein analysis for vitreous in the Group B, however, eyes treated with AMP alone at 24 and 48 hours postinoculation(p<0.05). On electrophysiologic study the decrease rate of the amplitude showed the difference between at 24 hours postinoculation and at 48 or 72 hours postinoculation(p<0.05). Histologic preparations showed a mild or moderate cellular infilteration in the vitreous and swelling in the sensory retina, but small abscess in the vitreous observed when treatment was delayed more than 72 hours following inoculation in both Group A and B. DXM in the experimental Candida endophthalmitis had the beneficial effect in eyes with 30,000 blastspore inoculation and in eyes treated with AMP and DXM at 24 hours postinoculation.