Retinal Toxicity of Vancomycin in Vitreous Replacement Fluid.

Jung, Won Sun; Oum, Boo Sup

Original Article

Journal of the Korean Ophthalmological Society 1993;34(12):1234-1241.
Published online December 1, 1993.

Retinal Toxicity of Vancomycin in Vitreous Replacement Fluid.

Won Sun Jung, Boo Sup Oum

Department of Ophthalmology, College of MedicIne, Pusan National University, Pusan, Korea.

초자체 관류액으로 사용한 vancomycin 의 안독성

정원선(Won Sun Jung),엄부섭(Boo Sup Oum)

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.

Key Words: Bacterial endophthalmitis;Intravitreal infusion;Retinal toxicity;Vancomycin