Improved Therapeutic Regimens for Treatment of Post-Traumatic Ocular Infections

摘要

Greater than 10% of battlefield injuries occur to the eyes, resulting in significant morbidity. The potential for ocular infection by trauma is high, due to the types of organisms encountered in arid environments and the delay between injury and adequate treatment. This proposal was designed to analyze the effectiveness of antibiotics, anti-inflammatory drugs, and non- conventional agents targeting bacterial and host virulence factors, with the goal of improving the outcome of infections that would otherwise result in vision loss. The 4th-year results highlight prompt and aggressive intravitreal and surgical therapy in preventing inflammation and vision loss. Delays in treatment result in vision loss, but may not result in loss of the eye, a cosmetic benefit. Analysis of additional anti-inflammatory agents with antibiotics suggests that these drugs are of little therapeutic benefit. The use of vitrectomy to clear intraocular inflammation and damaged tissue was of some benefit, but only when used in the early stages of infection. To date, early vitrectomy with antibiotics has been the only successful therapy in this model of severe endophthalmitis. We have been granted a 1-year no-cost extension to extend our studies. In the fifth year, we will complete our analysis of nonconventional therapies to identify those that may be implemented for future treatment of blinding bacterial infections of the eye.