Injection Of Povidone-iodine Research Articles

Effect of 0.625% Intravitreal Povidone-iodine injections in Patients with Endophthalmitis

Purpose: We report on three patients who received 0.625% povidone-iodine (PVI) intravitreal injections to treat endophthalmitis that did not respond to conventional antibiotic treatment or were inoperable.Case summary: Case 1 was a 42-year-old female with suspected left-eye endophthalmitis that developed after anterior chamber irrigation to treat silicone oil emulsification. A 0.625% PVI intravitreal injection reduced inflammation of the anterior chamber and the vitreous. Case 2 was an 84-year-old male who was blind in the left eye due to glaucoma. He was diagnosed with endogenous endophthalmitis on the basis of the anterior chamber hypopyon and vitreous inflammation. After 0.625% PVI intravitreal injection, the endophthalmitis resolved without any recurrence. Case 3 was a 49-year-old female with suspected endogenous left-eye endophthalmitis attributable to a liver abscess. Despite intravitreal antibiotic injections, the inflammation worsened. A 0.625% PVI intravitreal injection improved both the anterior chamber and vitreous inflammation.Conclusions: Intravitreal 0.625% PVI injection is a useful option when a patient with endophthalmitis is likely to not recover full vision, when surgery cannot be performed, and when there is no response to empirical antibiotics.

Endogenous Endophthalmitis successfully treated with Intravitreal Povidone-iodine injection: a case report

BackgroundThe usefulness of povidone-iodine as an alternative to antimicrobial agents, for endophthalmitis, has recently been documented. We report a case of endogenous endophthalmitis successfully treated with intravitreal injection of povidone-iodine.Case presentationAn 88-year-old woman underwent small bowel bypass surgery for postoperative ileus following rectal cancer resection. She developed a fever during total parenteral nutrition and was diagnosed with gram-positive cocci bacteremia of central venous catheter origin. The patient was referred to our department with chief complaints of ocular pain, hyperemia and decreased vision in the right eye, which had manifested during the febrile period. The initial examination revealed the visual acuity in her right eye to be finger counting and that in her left eye 0.2. The right eye showed a severe inflammatory reaction in the anterior chamber, fibrin deposition, and hypopyon. The fundus was difficult to visualize. Endogenous endophthalmitis due to bacteria was diagnosed.Surgical treatment was judged to be difficult based on the patient’s poor general condition and mental status, and intravitreal injection of 0.1 ml of 1.25% povidone-iodine was performed on the same day. The inflammation rapidly diminished, and the hypopyon had disappeared 4 days after treatment. The fundus became visible 7 days after treatment and there was no recurrence of endophthalmitis findings. The visual acuity in her right eye recovered to that in the left eye (0.2).ConclusionIntravitreal injection of povidone-iodine is potentially useful and effective as an alternative treatment of antibiotics for endogenous endophthalmitis patients, especially in whom surgical therapy is difficult.

EFFECT OF POVIDONE-IODINE ON THE SYNOVIAL MEMBRANE OF THE KNEE JOINT IN RATS

The effect of two different concentrations of povidone-iodine (PVI) solution, an antiseptic, on joint synovium was investigated. In Group I, 0.05 ml of 10% PVI was used, while in Group II, 0.05 ml of 2.5% of PVI was used. PVI solution was injected twice into both knee joints with one week interval. Ten rats were used as control and 70 rats as experimental. In the two experimental groups four rats were sacrificed after 6, 12, 24 hours and three day and six rats at the end of the week after the second PVI injection. Synovial reaction was assessed histologically in both groups, based on the pathological parameters. The results suggest that intra-articular injection of 10% and 2.5% PVI induces synovitis with focal ulceration which gradually subsides, and finally, the synovium becomes normal, though various degrees of subsynovial dense fibrosis complication arise.

THE EFFECT OF HYDROGEN PEROXIDE, POVIDONE-IODINE AND RUNNING LOADS ON RAT KNEE JOINT CARTILAGES

This study was performed to assess the effect of intra-articularly-injected 3.0% povidone-iodine solution and 2% H2O2on the joint cartilage. Ninety 12-week-old Spraque Dawley rats, weighing 250 g on average, were used; ten were used as controls without any treatment, and 80 were equally divided into four groups for the experiment. In group I, 0.05 ml of normal saline was injected twice into the right knee joints at intervals of one week each, and a running load over a treadmill was added until the animals were sacrificed. In group II, 0.05 ml of 2% H2O2was injected twice into the right knees over the same interval. In group III, 0.05 ml of 2% H2O2was injected twice into the right knees over the same weekly interval, and a running load was added until the knees were sacrificed. In group IV, 0.05 ml of 3.0% povidone-iodine was injected twice into the right knees at one week intervals and a running load was also added until their sacrifice. In each experimental group, five rats were sacrificed at two, four, six and eight weeks after the first intra-articular injection, respectively, and the medial femoral condyles of the joints were taken for histological study of the articular cartilage. After saline injection and running load were applied, stage-I cartilage degeneration was observed at eight weeks after the first saline injection. After H2O2injection only, stage-I cartilage degeneration was observed at four and six weeks, and the changes progressed to Wagenhäuser stage-II degeneration at eight weeks. After H2O2injection and running load were applied, there were no histologic changes by two weeks, but stage-II cartilage degeneration was induced as early as six weeks after the first H2O2injection. After povidone-iodine injection and running load were applied, stage-I cartilage degeration was observed at two weeks, and was maintained up to six weeks. Stage-II degeneration was observed at eight weeks. The matriceal proteoglycan contents was relatively high in comparison with the other groups. Safranin-O stain reduction was observed in groups I, II, III and IV before the histological changes were being observed. From the results, it was found that 3.0% povidone-iodine and 2% H2O2with running loads could induce cartilage damage, and that 3.0% povidone-iodine solution induced more damage to the cartilage than 2% H2O2.

The Effect of Hydrogen Peroxide, Povidone-Iodine and Running Loads on Rat Knee Joint Cartilages

This study was performed to assess the effect of intra-articularly-injected 3.0% povidone-iodine solution and 2% H2O2 on the joint cartilage. Ninety 12-week-old Spraque Dawley rats, weighing 250 g on average, were used; ten were used as controls without any treatment, and 80 were equally divided into four groups for the experiment. In group I, 0.05 ml of normal saline was injected twice into the right knee joints at intervals of one week each, and a running load over a treadmill was added until the animals were sacrificed. In group II, 0.05 ml of 2% H2O2 was injected twice into the right knees over the same interval. In group III, 0.05 ml of 2% H2O2 was injected twice into the right knees over the same weekly interval, and a running load was added until the knees were sacrificed. In group IV, 0.05 ml of 3.0% povidone-iodine was injected twice into the right knees at one week intervals and a running load was also added until their sacrifice. In each experimental group, five rats were sacrificed at two, four, six and eight weeks after the first intra-articular injection, respectively, and the medial femoral condyles of the joints were taken for histological study of the articular cartilage. After saline injection and running load were applied, stage-I cartilage degeneration was observed at eight weeks after the first saline injection. After H2O2 injection only, stage-I cartilage degeneration was observed at four and six weeks, and the changes progressed to Wagenhauser stage-II degeneration at eight weeks. After H2O2 injection and running load were applied, there were no histologic changes by two weeks, but stage-II cartilage degeneration was induced as early as six weeks after the first H2O2 injection. After povidone-iodine injection and running load were applied, stage-I cartilage degeration was observed at two weeks, and was maintained up to six weeks. Stage-II degeneration was observed at eight weeks. The matriceal proteoglycan contents was relatively high in comparison with the other groups. Safranin-O stain reduction was observed in groups I, II, III and IV before the histological changes were being observed. From the results, it was found that 3.0% povidone-iodine and 2% H2O2 with running loads could induce cartilage damage, and that 3.0% povidone-iodine solution induced more damage to the cartilage than 2% H2O2.

Intraperitoneal povidone-iodine in experimental canine and murine peritonitis

In dogs with appendicitis-peritonitis, intraperitoneal povidone-iodine caused death more rapidly than the instillation of saline solution. The bacterial content of canine peritoneal fluid increased with time. Although fewer bacteria were found in fluid from povidone-iodine-treated dogs, the differences were not statistically significant. Qualitative chemical analysis of peritoneal fluid revealed iodide, but not free iodine, 15 to 30 minutes after instillation of povidone-iodine. Iodide was present in the peritoneum at 2 hours but not at 3 or 6 hours. The antibacterial effect of povidone-iodine was demonstrated in mice challenged intraperitoneally with lethal doses of Escherichia coli. Povidone-iodine diminished mortality when injected immediately (p < 0.005) but not when given 1 to 3 hours later. Immediate injection of povidone-iodine into mice lowered the number of E. coli by 3 logs. Injection of povidone-iodine 3 hours after bacterial challenge lowered the number of E. coli by only 1 3 log. This lesser bactericidal effect in mice is attributed to greater dispersal and sequestration of bacteria throughout the peritoneal cavity with time and with inactivation of povidoneiodine by reduction to iodide in vivo. In dogs with appendicitis-peritonitis, the more rapid death after treatment with povidone-iodine was not associated with differences in peritoneal microflora but with peritoneal absorption of excessive amounts of iodide.