Effect of Intravitreal Triamcinolone Acetonide in the Treatment of Experimental<i>Staphylococcus epidermidis</i>Endophthalmitis

Hosseini, Hamid; Mehryar, M; Eghtedari, Masoomeh; Ahmadi, Farzin; Nowroozizadeh, Sarah

doi:10.1080/02713680802585938

Cited by 9 publications

(8 citation statements)

References 27 publications

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“…We [3] reported that the kinetics and degrees of intraocular inflammation caused by B. cereus , S. aureus , and E. faecalis were highly variable, suggesting that the intraocular immune response is organism-dependent. This is clearly the case with relatively avirulent organisms such as S. epidermidis , which causes infection and inflammation in the eye only at high concentrations [32], [33]. Suggested development of therapeutics that target pattern recognition receptors must therefore not only account for organism-dependent differences in recognition, but also realistic timing of administration for different infection scenarios.…”

Section: Discussionmentioning

confidence: 99%

Role of Toll-Like Receptor (TLR) 2 in Experimental Bacillus cereus Endophthalmitis

2011

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Bacillus cereus causes a uniquely rapid and blinding intraocular infection, endophthalmitis. B. cereus replicates in the eye, synthesizes numerous toxins, and incites explosive intraocular inflammation. The mechanisms involved in the rapid and explosive intraocular immune response have not been addressed. Because Toll-like receptors (TLRs) are integral to the initial recognition of organisms during infection, we hypothesized that the uniquely explosive immune response observed during B. cereus endophthalmitis is directly influenced by the presence of TLR2, a known Gram-positive pathogen recognition receptor. To address this hypothesis, we compared the courses of experimental B. cereus endophthalmitis in wild type C57BL/6J mice to that of age-matched homozygous TLR2-/- mice. Output parameters included analysis of bacterial growth, inflammatory cell (PMN) infiltration, cytokine/chemokine kinetics, retinal function testing, and histology, with N≥4 eyes/assay/time point/mouse strain. B. cereus grew at similar rates to108 CFU/eye by 12 h, regardless of the mouse strain. Retinal function was preserved to a greater degree in infected TLR2-/- eyes compared to that of infected wild type eyes, but infected eyes of both mouse strains lost significant function. Retinal architecture was preserved in infected TLR2-/- eyes, with limited retinal and vitreal cellular infiltration compared to that of infected wild type eyes. Ocular myeloperoxidase activities corroborated these results. In general, TNFα, IFNγ, IL6, and KC were detected in greater concentrations in infected wild type eyes than in infected TLR2-/- eyes. The absence of TLR2 resulted in decreased intraocular proinflammatory cytokine/chemokine levels and altered recruitment of inflammatory cells into the eye, resulting in less intraocular inflammation and preservation of retinal architecture, and a slightly greater degree of retinal function. These results demonstrate TLR2 is an important component of the initial ocular response to B. cereus endophthalmitis.

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Section: Discussionmentioning

confidence: 99%

Role of Toll-Like Receptor (TLR) 2 in Experimental Bacillus cereus Endophthalmitis

2011

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“…8 Notably, the use of intravitreal triamcinolone attenuates the level of tissue damage caused by the inflammatory cascade in an S. epidermidis infection. 11 Under septic conditions caused by grampositive organisms, cytokines are released causing shock, 8 which may induce a localized disseminated intravascular coagulation (DIC) that causes retinal necrosis and macular infarction. A critical mediator of DIC is the release of a transmembrane glycoprotein called the tissue factor, which has a major role in the development of DIC in septic conditions.…”

Section: Discussionmentioning

confidence: 99%

Macular Infarction Secondary to Staphylococcus Epidermidis Infection

Kunjukunju¹,

Gonzales²,

Rodden³

2012

RETINAL Cases &Amp; Brief Reports

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“…25 There were two preclinical studies examining the use of IVT triamcinolone acetonide in acute Staphylococcus epidermidis . 26–27 There were one retrospective 28 and one pilot case series 29 looking at adjunctive IVT triamcinolone acetonide in addition to one retrospective case series looking at adjunctive IVT prednisolone 30 in acute endophthalmitis. There were 10 retrospective case series and 3 prospective randomized case series investigating the use of IVT dexamethasone.…”

Section: Methodsmentioning

confidence: 99%

“…26 However, in the presence of appropriate antibiotics, both studies reported that IVT triamcinolone attenuates the clinical signs of inflammation without impairing the therapeutic effect. 26–27 Taking this a step further, the second study even found a reduction in pathologic damage associated with adjunctive IVT triamcinolone. 27 These results are similar with those reported in most studies investigating the effect of IVT dexamethasone in addition to IVT antibiotics in Staphylococcus epidermidis endophthalmitis.…”

Section: The Effect Of Ivt Corticosteroids In Preclinical Studies Of mentioning

confidence: 97%

Evidence for and Against Intravitreous Corticosteroids in Addition to Intravitreous Antibiotics for Acute Endophthalmitis

Bui

Carvounis

2014

International Ophthalmology Clinics

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The use of adjunctive intravitreous corticosteroids in endophthalmitis is controversial. Preclinical models showed that early administration of corticosteroids may be important although they reported mixed results in terms of their effects on antibiotic pharmacokinetics, control of infection and prevention of retinal damage. Most published retrospective clinical studies showed no beneficial effects associated with their use. However, a single well-conducted retrospective study showed a deleterious effect. Randomized controlled trials also showed a lack of beneficial effects. At the present time, the best available evidences do not support the routine use of adjunctive intravitreous corticosteroids for treatment of acute endophthalmitis.

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Effect of Intravitreal Triamcinolone Acetonide in the Treatment of ExperimentalStaphylococcus epidermidisEndophthalmitis

Abstract: A standard clinical dose of intravitreal TA attenuates the clinical signs and tissue destruction in a rabbit model of Staphylococcus epidermidis endophthalmitis.

Cited by 9 publications

References 27 publications

Role of Toll-Like Receptor (TLR) 2 in Experimental Bacillus cereus Endophthalmitis

Role of Toll-Like Receptor (TLR) 2 in Experimental Bacillus cereus Endophthalmitis

Macular Infarction Secondary to Staphylococcus Epidermidis Infection

Evidence for and Against Intravitreous Corticosteroids in Addition to Intravitreous Antibiotics for Acute Endophthalmitis

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