ro13-9904 and Cataract

Streptococcus pneumoniae endophthalmitis is clinically more severe, more difficult to treat, and carry a higher risk of vision loss, evisceration, or enucleation. This study is to investigate the clinical settings, antibiotic susceptibility, and visual outcomes of S. pneumoniae endophthalmitis at a tertiary referral center in Taiwan. S. pneumoniae endophthalmitis was diagnosed in 38 eyes of 38 patients. The main clinical features were postcataract endophthalmitis (n = 13, 34%) and endophthalmitis associated with corneal ulcer (n = 12, 32%), trauma (n = 6, 16%), endogenous etiology (n = 4, 11%), trabeculectomy (n = 2, 5%), and pterygium excision-related scleral ulcer (n = 1, 3%). Presenting visual acuity ranged from counting fingers to no light perception. Pars plana vitrectomy with intravitreal antibiotics was performed in 17 eyes (39%) in primary or secondary treatments. S. pneumoniae isolates were susceptible to vancomycin (38/38, 100%), penicillin (37/38, 97%), ceftriaxone (37/38, 97%), cefuroxime (12/15, 80%), levofloxacin (13/15 ,87%), and moxifloxacin (15/17, 88%). Final visual acuity was better than 20/400 in 3 of 38 eyes (8%), 5/200 to hand motions in 3 eyes (8%), and light perception to no light perception in 32 eyes (84%). Ten eyes (26%) underwent evisceration or enucleation. Although S. pneumoniae isolates were susceptible to vancomycin, S. pneumoniae endophthalmitis had a very poor visual prognosis.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Cataract; Cataract Extraction; Ceftriaxone; Cefuroxime; Corneal Ulcer; Endophthalmitis; Eye Enucleation; Eye Injuries; Female; Humans; Levofloxacin; Male; Microbial Sensitivity Tests; Middle Aged; Moxifloxacin; Penicillins; Pneumococcal Infections; Retrospective Studies; Severity of Illness Index; Streptococcus pneumoniae; Taiwan; Tertiary Care Centers; Trabeculectomy; Treatment Outcome; Vancomycin; Vitrectomy

Topics: Adult; Amikacin; Cataract; Cataract Extraction; Ceftriaxone; Drug Therapy, Combination; Eye Infections, Fungal; Humans; Immunosuppressive Agents; Kidney Transplantation; Male; Nocardia Infections; Postoperative Complications; Transplantation, Homologous; Trimethoprim, Sulfamethoxazole Drug Combination

Ocular toxic effects of intravitreally injected ceftriaxone sodium and its rate of clearance after a single dose were studied in rhesus and cynomolgus monkeys. Doses of 2, 2.5, and 3 mg/0.1 mL were injected into the vitreous cavity. Electroretinograms performed 15 minutes, 24 hours, one week, and two weeks after injection were not significantly different from preinjection electroretinograms. Lens opacification occurred in one eye receiving 2.5 mg of ceftriaxone. Histopathologic findings in the retina were normal in all eyes injected intravitreally. Levels of ceftriaxone after a 2-mg intravitreal dose were 609 mg/L at 0 hours, 434 mg/L at 24 hours, and 19 mg/L at 100 hours in the vitreous; and 1 mg/L at 0 hours, 116 mg/L at 24 hours, and 9 mg/L at 100 hours in the aqueous.

Topics: Animals; Aqueous Humor; Cataract; Cefotaxime; Ceftriaxone; Electroretinography; Female; Kinetics; Macaca fascicularis; Macaca mulatta; Male; Vitreous Body