An Intravitreal Amphotericin B Drug Delivery System For The Treatment Of Experimental Aspergillus Fumigatus Endophthalmitis

Objective To observe a new kind of Amphotericin B Drug Delivery System (AmB-DDS), and investigate the therapeutic effect of AmB-DDS in an experimental Aspergillus fumigatus endophthalmitis. Mathod 1, To observe the effect of AmB-DDS. Fifty New Zealand albino rabbits were intravitreal injected Aspergillus fumigatus suspension (10~3 colony forming unit, CFU)in applanation of vitreous body before therapy three 48 hours. All models were randomly divided into seven groups. Group A is the empty control group, treat nothing after Aspergillus fumigatus injection;group B is the empty DDS implanted group, not treated after DDS implanted;group C : AmB 0.5 μ g-injected group, the injection were repeated two week later, group D: 250 μ g AmB-DDS intravitreal implanted combined vitrectomy group. Group E: 500 μ g AmB-DDS intravitreal implanted combined vitrectomy group, group D: 250 μ g AmB-DDS intravitreal implanted vitrectomy group. Group E: 500 μ g AmB-DDS intravitreal implanted group. Aqueous flare, cells, anterior vitreous cells and vitreous opacity, vitreous humor smear and culture were graded clinically at different times after operation for 8 weeks. After two months later after operation, light microscopy was used to evaluated the possible scathe of the structure in the eyes. 2, To observe the release of AmB-DDS .Group H: 500 μ g AmB-DDS were implanted in the eye of rabbits after vitrectomy in order to observe the drug releasing;Vitreous humor was aspirated and concentrations of amphotericin B were determined by high performance liquid chromatography (HPLC), To confirm if there's sustained Amphotericin released in the AmB-DDS during the observational period. Result the inflammation grade of group A,B,C,D,E,F,G: The inflammation grade was lower in groups C,D,E,G than groups A,B. There's significant statistical difference between groups C,D,E,G and groups A,B (P≤ 0.002) . The inflammation grade was lower in groups C,E than group F. There's significant statistical difference between groups C,E and group F (P≤0.002) . Theinflammation grade was lower in group E than group C. There's significant statistical difference between groups E and groups C (P≤0.002) . The inflammation grade was lower in group D than group F. There's significant statistical difference between group D and group F (P≤0.002). All of vitreous humor smears is positive in 1.5 months, and the culture is positive of A,B groups. Histopathological exam indicated that the eyes of Aspergillus endophthalmitis have collapsed. During our observation periods, there's sustained AmB release in the AmB-DDS. The rules of AmB drug delivery is benefited to Aspergillus fumigatus endophthalmitis therapy. Conclusion The degradable AmB-DDS can effectively suppress the inflammation of the rabbit model of Aspergillus fumigatus endophthalmitis. As an alternative to the current routine therapy, it can be used for the treatment of Aspergillus fumigatus endophthalmitis. The dose of 500 μ g is benefit to control this infection, and vetrectomy is also benefit to control this infection.