| Objective: The establishment of fungal intraocular inflammation animal models,and the voriconazole and amphotericin B liposome are injected into animal modelsrespectively, Observe the effect of two drugs on the treatment of fungal eyeinflammation.Method:30guinea pigs are involved; the aspergillus fumigatus sporesuspension with concentration of1×106CFU/mL is injected into vitreous body, Theestablishment of fungal intraocular inflammation animal models, and the treatmentand observation are carried out after24hours. The guinea pigs in the experiment aredivided into three groups randomly, and there are10guinea pigs in each group:Control Group A; Control group; Experimental Group B: voriconazole solution withconcentration of20ug/0.02mL is injected into vitreous body; Experimental Group C：amphotericin B liposome solution with concentration of20ug/0.02mL is injected intovitreous body. The corneal opacity, the inflammatory response of anterior chamberand vitreous opacity are observed at different time points after operation; the vitreouscavity fluid is extracted to make smear and fungal and mycelium culture for the sakeof observation; ERG examination and histopathological examination are carried outand treatment effect is evaluated.Result: Group A shows endophthalmitis with obvious symptom, and it developsinto panophthalmitis fast, and finally, atrophy of eyeball. The postoperativeinflammatory response in Group B and C are both milder than that in Group A; theclinical manifestation of Group B with voriconazole after operation is the mildest，the degrees of corneal opacity, the inflammatory response of anterior chamber andvitreous opacity1to3days after operation are of no significant difference in Group Band Group C (P>0.05)；the degrees of corneal opacity, the inflammatory response ofanterior chamber and vitreous opacity3to14days after operation are of significantdifference in Group B and Group C (P<0.05)；the degrees of corneal opacity, theinflammatory response of anterior chamber and vitreous opacity14to28days afteroperation are of no significant difference in Group B and Group C (P>0.05)；28daysafter operation, eye grounds of inflammation-controlled eyes in Group B and Group Care clear, and no recurrence can be seen. In group A, vitreous cavity fluid smear andfungal culture1day,7days,14days and28days after operation are all positive, and alarge number of fungal hyphae can be seen; in Group B and Group C, vitreous cavity fluid smear and fungal culture1day and7days after operation are both positive, andvitreous cavity fluid smear and fungal culture14days and28days after operation areboth negative. In ERG examination of Group A，b-wave amplitude decreases，andincubation period prolongs; in ERG examination of Group B and Group C, b-waveamplitude and incubation period are of no significant difference before and aftertreatment, and changes in Group B and Group C are identical. In histopathologicalexamination7days after operation，in Group A, disorganized retina cells can be seen,and structure is destroyed, while structure of layers is indistinct; it can be seen thathyphae of aspergillus fumigatus and a large amount of inflammatory cells areinfiltrating in vitreous body; in Group B sporadic inflammatory cells and hyphae ofaspergillus fumigatus can be seen in vitreous body, and retina structure is basicallyintact; in Group C, aggregation of inflammatory cells and hyphae of aspergillusfumigatus can be seen in vitreous body, and retina structure is generally normal;14days after operation, in Group A, new vessels can be seen in corneal stroma, and alarge amount of oaspergillus fumigatus hyphae can be seen in vitreous body, andretina structure is destroyed and disappeared; in Group B, sporadic inflammatory cellsare infiltrating vitreous body, and structure of retina are generally normal; in Group C,sporadic inflammatory cells are infiltrating and a small amount of oaspergillusfumigatus hyphae are aggregating in vitreous body, and retina structure is basicallynormal;28days after operation, in Group A, anterior chamber and vitreous body arefilled with a large amount of purulent solid, and a large amount of inflammatory cellsand hyphae of aspergillus fumigatus can be seen in vitreous body, and structure ofretina and choroid cannot be distinguished; in Group B、C, structure of cornea,vitreous body and retina are basically normal.Conclusion: The injections of voriconazole and Amphotericin B Liposomesolution to guinea pigs at early stage are effective treatment methods for aspergillusfumigatus endophthalmitis, and compared with amphotericin B liposome,voriconazole takes effect more quickly. |
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