Objective: To investigate the penetration of 0.5% moxifloxacin hydrochloride into the aqueous and vitreous after topical administration in humans. Methods: A prospective, nonrandomized study of 20 patients scheduled f...Objective: To investigate the penetration of 0.5% moxifloxacin hydrochloride into the aqueous and vitreous after topical administration in humans. Methods: A prospective, nonrandomized study of 20 patients scheduled for vitrectomy surgery between September 1 and December 31, 2003. Aqueous and vitreous samples were obtained and analyzed after topical administration of 0.5% moxifloxacin hydrochloride, every 2 hours (q2h) or every 6 hours (q6h), for 3 days before surgery. Assays were performed using high-performance liquid chromatography. Results: Mean± SD moxifloxacin concentrations in the q2h group for the aqueous (n=9) and vitreous (n=10) were 2.28± 1.23 and 0.11± 0.05 μ g/mL, respectively. Mean± SD moxifloxacin concentrations in the q6h group for the aqueous (n=10) and vitreous (n=9) were 0.88± 0.88 and 0.06 ± 0.06 μ g/mL, respectively. The minimum inhibitory concentration for 90% of isolates (MIC90) was far exceeded in the aqueous for a wide spectrum of key pathogens, whereas it was not exceeded in the vitreous for several organisms. However, the minimum inhibitory concentration for 50% of the isolates was exceeded in the q2h vitreous group for Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Bacillus cereus, and other gram-negative pathogens. Conclusions: The Endophthalmitis Vitrectomy Study revealed that 94.2% of isolates from postoperative endophthalmitis are gram-positive pathogens. Moxifloxacin has a spectrum of coverage that appropriately encompasses the most common organisms in endophthalmitis. The pharmacokinetic findings of this investigation show that relatively high aqueous levels can be achieved after topical administration. Further studies will help define the precise role of 0.5% moxifloxacin ophthalmic solution in the treatment of or prophylaxis against intraocular infections.展开更多
To report the results of treating juxtafoveal choroidal neovascularization with photodynamic therapy using verteporfin in eyes with age-related macular degeneration. Seven patients with predominantly classic juxtafove...To report the results of treating juxtafoveal choroidal neovascularization with photodynamic therapy using verteporfin in eyes with age-related macular degeneration. Seven patients with predominantly classic juxtafoveal choroidal neovascularization were treated by photodynamic therapy using verteporfin. Three of the 7 patients had a gain in visual acuity and 2 had a stabilization of vision. The remaining 2 patients had a decrease in visual acuity. Subfoveal extension of the choroidal neovascularization was not observed in any patient and all choroidal neovascularization lesions after treatment were found to be nonperfused on fluorescein angiography. The encouraging results based on this small pilot study suggest that photodynamic therapy should be considered for treatment of select juxtafoveal choroidal neovascularization due to age-related macular degeneration.展开更多
文摘Objective: To investigate the penetration of 0.5% moxifloxacin hydrochloride into the aqueous and vitreous after topical administration in humans. Methods: A prospective, nonrandomized study of 20 patients scheduled for vitrectomy surgery between September 1 and December 31, 2003. Aqueous and vitreous samples were obtained and analyzed after topical administration of 0.5% moxifloxacin hydrochloride, every 2 hours (q2h) or every 6 hours (q6h), for 3 days before surgery. Assays were performed using high-performance liquid chromatography. Results: Mean± SD moxifloxacin concentrations in the q2h group for the aqueous (n=9) and vitreous (n=10) were 2.28± 1.23 and 0.11± 0.05 μ g/mL, respectively. Mean± SD moxifloxacin concentrations in the q6h group for the aqueous (n=10) and vitreous (n=9) were 0.88± 0.88 and 0.06 ± 0.06 μ g/mL, respectively. The minimum inhibitory concentration for 90% of isolates (MIC90) was far exceeded in the aqueous for a wide spectrum of key pathogens, whereas it was not exceeded in the vitreous for several organisms. However, the minimum inhibitory concentration for 50% of the isolates was exceeded in the q2h vitreous group for Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Bacillus cereus, and other gram-negative pathogens. Conclusions: The Endophthalmitis Vitrectomy Study revealed that 94.2% of isolates from postoperative endophthalmitis are gram-positive pathogens. Moxifloxacin has a spectrum of coverage that appropriately encompasses the most common organisms in endophthalmitis. The pharmacokinetic findings of this investigation show that relatively high aqueous levels can be achieved after topical administration. Further studies will help define the precise role of 0.5% moxifloxacin ophthalmic solution in the treatment of or prophylaxis against intraocular infections.
文摘To report the results of treating juxtafoveal choroidal neovascularization with photodynamic therapy using verteporfin in eyes with age-related macular degeneration. Seven patients with predominantly classic juxtafoveal choroidal neovascularization were treated by photodynamic therapy using verteporfin. Three of the 7 patients had a gain in visual acuity and 2 had a stabilization of vision. The remaining 2 patients had a decrease in visual acuity. Subfoveal extension of the choroidal neovascularization was not observed in any patient and all choroidal neovascularization lesions after treatment were found to be nonperfused on fluorescein angiography. The encouraging results based on this small pilot study suggest that photodynamic therapy should be considered for treatment of select juxtafoveal choroidal neovascularization due to age-related macular degeneration.
