Evidence for and against intravitreous corticosteroids in addition to intravitreous antibiotics for acute endophthalmitis

Int Ophthalmol Clin. 2014 Spring;54(2):215-24. doi: 10.1097/IIO.0000000000000020.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Disease
  • Adrenal Cortex Hormones* / administration & dosage
  • Anti-Bacterial Agents / administration & dosage*
  • Contraindications
  • Drug Therapy, Combination
  • Endophthalmitis / drug therapy*
  • Humans
  • Intravitreal Injections
  • Ophthalmologic Surgical Procedures / adverse effects
  • Postoperative Complications / drug therapy

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents