The Efficacy of Intravitreal Povidone Iodine Application in Experimental <i>Staphylococcus epidermidis</i> Endophthalmitis

Abstract

Aim: The aim of the current study is to evaluate the role of povidone iodine (PVI) in the management of experimental bacterial endophthalmitis in young rabbits. Method: Twenty white rabbits were used. Colony-forming units (CFU) of Staphylococcus epidermidis were injected intravitreally into the right eye of each animal. Injected eyes were evaluated clinically daily (anterior and posterior segment examination), and when clinical signs of endophthalmitis appeared, an injection of 0.1 ml PVI was made intravitreally. In group 1 (n = 10), the injected concentration of PVI was 0.1%, and in group 2 (n = 10) the concentration was 0.2%. At the end of the observation period, vitreous sample culture was made, and vitreous and retina specimens were taken for light histology examination as well. Results: Group 1 eyes did not show any signs of clinical improvement. Vitreous culture showed the presence of 10⁸ CFU/ml of S. epidermidis. Histological examination indicated acute inflammation. Group 2 animals presented a clear gradual regression of the inflammation. Vitreous culture for S. epidermidis proved to be sterile. Histological examination indicated chronic inflammation. Conclusions: Intravitreal injection of 0.2% PVI is likely to inhibit bacterial endophthalmitis of rabbit eyes due to S. epidermidis.

Intravitreal Injection of 1.25% Povidone Iodine Followed by Vitrectomy Using 0.025% Povidone Iodine Irrigation for Treating Endophthalmitis

“…The in vitro study of Van den Broek et al24 demonstrated PI to exert a bactericidal effect at concentrations of 0.005% and higher. In addition, Brozou et al25 performed IVI of PI in rabbit eyes with Staphylococcus epidermidis endophthalmitis ( n = 10) and reported that at an intravitreal PI concentration of 0.00625% (0.1%/0.1 mL) produced no clinical improvement, while 0.013% (0.2%/0.1 mL) was effective. However, flare persisted in the vitreous after injection, but the inflammation gradually subsided and vitreous culture after 1 month yielded no S. epidermidis 25.…”

“…In addition, Brozou et al25 performed IVI of PI in rabbit eyes with Staphylococcus epidermidis endophthalmitis ( n = 10) and reported that at an intravitreal PI concentration of 0.00625% (0.1%/0.1 mL) produced no clinical improvement, while 0.013% (0.2%/0.1 mL) was effective. However, flare persisted in the vitreous after injection, but the inflammation gradually subsided and vitreous culture after 1 month yielded no S. epidermidis 25. From these findings, addition of PI at a concentration in the range from 0.013 to 0.027 to irrigation solution was thought to be a safe and effective treatment for endophthalmitis.…”

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

“…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.…”

Evaluation of Retinal Function and Pathology After Intravitreal Injection of Povidone-Iodine and Polyvinyl Alcohol-Iodine in Rabbits

“…5). Brozou et al 37 reported that intravitreal injection of PI with 0.01% available iodine (0.00067% in rabbit vitreous) did not inhibit bacterial endophthalmitis, whereas PI with 0.02% available iodine (0.0013% in rabbit vitreous) was likely to inhibit bacterial endophthalmitis. From their findings and the results of this study, the effective vitreous concentration range for endophthalmitis without retinal toxicity can be calculated as 0.0013% to 0.0033%.…”