Bioavailability and corneal anti-inflammatory effect of topical suprofen

The bioavailability in rabbit cornea and aqueous humor of an ophthalmic formulation of suprofen, a nonsteroidal anti-inflammatory drug, was evaluated following topical administration of a single dose to the eye. The drug penetrated rapidly into the uninflamed cornea with intact epithelium; highest levels occurred during the first 30 to 45 min after instillation and decreased thereafter. The bioavailability of suprofen in cornea and aqueous humor following administration of a 1.0% concentration was twice that produced by a 0.5% concentration of the drug. Topical application of multiple doses of suprofen failed to suppress polymorphonuclear leukocyte invasion of the cornea if treatment was started after the induction of inflammation. Suprofen therapy initiated prior to the induction of corneal inflammation and maintained into the post-inflammation period did produce a significant (P less than 0.01) decrease in the numbers of PMNs that invaded the inflamed cornea. There was no significant difference (P greater than 0.05) in the corneal anti-inflammatory effect achieved by the 0.5% and 1.0% concentrations of suprofen when administered according to this regimen.     

Therapeutic response of herpes simplex virus-induced corneal edema to trifluridine in combination with immunosuppressive agents

Herpetic stromal disease often is treated with combinations of antiviral agents and corticosteroids. The addition of steroids to the antiviral treatment regimen frequently increases the efficacy of therapy in patients; however, many complications may arise as a result of corticosteroid therapy. Using a rabbit model, the effects of trifluridine (F3TdR) on corneal edema and stromal disease were examined when combined with each of three immunosuppressive agents. The therapeutic response was evaluated by classifying eyes as either responsive or unresponsive based on the maximum corneal thickness attained during therapy. The data indicate that about 56% of the eyes responded to therapy with 1% F3TdR alone even when therapy was initiated after signs of stromal inflammation had begun to appear and epithelial disease was resolving. Combination of F3TdR with 0.125% prednisolone acetate significantly increased the proportion of responsive eyes to about 78%. Therapy with F3TdR combined with topical 5% cyclosporine A was no better than F3TdR alone, and combination with 0.2% deoxycoformycin and 0.4% 2'-deoxyadenosine significantly decreased the proportion of responsive eyes. These data further document that the responses of stromal disease to therapy must be evaluated on an eye-by-eye basis because the distribution of the data may not be Gaussian in nature. Eyes with corneal edema and stromal disease induced by herpes simplex viral (HSV) infection may respond to therapy with antiviral agents alone, but others require steroid. Still others do not respond to combined therapy. Combining the responses of all eyes in a given treatment group to obtain a "population mean" may be misleading.(ABSTRACT TRUNCATED AT 250 WORDS)     

Fluorometholone acetate: clinical evaluation in the treatment of external ocular inflammation

Separate, randomized, double-masked clinical studies were conducted to determine the therapeutic efficacy of fluorometholone acetate, a new ophthalmic corticosteroid formulation, in suppressing external ocular inflammation (conjunctivitis, episcleritis, scleritis). Fluorometholone acetate 0.1% was compared to fluorometholone 0.1%, and the acetate formulation was found to be significantly (p = 0.03) more effective. Fluorometholone acetate 0.1% also was compared to prednisolone acetate 1.0%; there was no significant difference (p = 0.49) between these two corticosteroids in their ability to suppress external ocular inflammation. It appears that alteration of fluorometholone from its alcohol base to its acetate derivative changes the drug from a moderately effective to a highly effective anti-inflammatory agent.     

Sympathische Ophthalmie

This article describes the case of a 48-year-old male patient who presented with persistent inflammation and deterioration of vision to a best corrected visual acuity (BCVA) of 0.6 in the only functioning left eye. The right eye had suffered a severe penetrating ocular trauma 6 months prior to presentation. After diagnosis of a sympathetic ophthalmia a high dosage corticosteroid therapy was initiated. Due to intolerance with decompensating diabetes an immunosuppressive therapy with azathioprine was initiated. This therapy resulted in stable clinical findings with an increase in BCVA to 0.9.     

Studies on corticosteroid therapy in Vogt-Koyanagi-Harada disease

We evaluated the significance of corticosteroid therapy on 47 new patients with Vogt-Koyanagi-Harada disease examined in the Uveitis Survey Clinic of the Hokkaido University Hospital. All patients were treated with topical corticosteroids, with or without systemic corticosteroids. 18 patients received systemic corticosteroid as pulse therapy, 20 patients received high-dose corticosteroid starting with prednisolone 200 mg, 2 patients received conventional-dose corticosteroid and 7 patients received no systemic corticosteroid therapy. When we evaluated the results 6 months after the initiation of treatment, anterior chamber inflammation was significantly less in patients with pulse and high-dose corticosteroid therapy than in those without systemic corticosteroid therapy. Furthermore, final visual acuity was significantly better in patients with pulse and high-dose corticosteroid than in those without them. However, there was no significant difference between patients with pulse therapy and those with high-dose corticosteroid therapy. The findings are in support of systemic corticosteroid therapy (pulse and high-dose) in the treatment of Vogt-Koyanagi-Harada disease.     

Comparison of the prophylactic effects of 2-deoxycytidine and prednisolone for high-dose intravenous cytarabine-induced keratitis

In a double-masked, randomized fashion, 11 patients with hematologic malignancies received 13 courses of high-dose cytarabine therapy, intravenously (3 g/m2 every 12 hours for five to six days). Each patient received topical prednisolone phosphate 1% in one eye and 2-deoxycytidine 100 microM in the other eye every six hours. Topical therapy was initiated 12 hours before the first cytarabine dose and continued for up to ten days (until four to five days after completion of cytarabine therapy). Slit-lamp biomicroscopy was performed before therapy and then weekly for one month. 2-Deoxycytidine was equally as effective as the topical corticosteroid therapy in reducing photophobia and pain, microcysts, and punctate epithelial erosions, and each treatment gave results significantly better when compared historically to placebo-treated eyes.     

The efficacy of sirolimus in the treatment of patients with refractory uveitis

AIMS: To determine the efficacy of sirolimus in the treatment of patients with severe non-infectious uveitis. METHODS: Eight patients with severe non-infectious uveitis were recruited to an open study. Inclusion criteria were limited to patients whose disease was not controlled with at least two or more separate steroid sparing immunosuppressants (either because of unacceptable side effects or ineffectiveness of the drug) or who required regular doses of corticosteroids either as high dose systemic or orbital floor injections in order to control their disease. Intraocular inflammation, visual acuity, symptoms, corticosteroid burden, drug toxicity, and side effects were monitored. RESULTS: Sirolimus therapy was effective in five of the eight patients, all of whom had their dose of corticosteroids reduced or discontinued. Treatment in three patients was considered a failure as it caused intolerable side effects and/or failed to control the uveitis. Side effects were common and were typically gastrointestinal or cutaneous in nature. The severity of symptoms was dose dependent in most cases and occurred at trough blood levels above 25 ng/ml. CONCLUSION: Sirolimus is an effective and potent immunosuppressive treatment in the majority of patients with non-infectious uveitis and can reduce the need for long term supplementary corticosteroid therapy. Further studies are required to establish the long term efficacy and safety of sirolimus alone or in combination with other steroid sparing immunosuppressants.     

Anti-inflammatory efficacy of a single posterior subtenon injection of triamcinolone acetonide versus prednisolone acetate 1% eyedrops after pars plana vitrectomy

PURPOSE: To compare the safety and anti-inflammatory efficacy of a single posterior subtenon injection of triamcinolone acetonide (TA) with prednisolone acetate 1% eyedrops after pars plana vitrectomy (PPV). METHODS: The study included 40 consecutive phakic eyes of 40 patients undergoing PPV for non-clearing vitreous haemorrhage with attached retina (verified by echography), epiretinal membrane or macular hole. At the end of the surgical procedure, eyes were randomized to receive either a single posterior subtenon injection of TA (40 mg in 1 ml) plus sham eyedrops (prednisolone acetate 1% vehicle) postoperatively (group TA), or a posterior subtenon sham injection (1 ml balanced salt solution) plus prednisolone acetate 1% eyedrops postoperatively (group ED). RESULTS: There was no difference in the severity of anterior chamber cell and flare between the two groups at any time-point during the study period (p > 0.05). Separate within-group analysis revealed a significant decrease in anterior chamber cell and flare from postoperative day 1 to postoperative days 7, 14 and 28 in both groups (p < 0.05). There was no difference in pain, photophobia, conjunctival erythema, ciliary flush or chemosis scores between the two groups at any time-point during the study period (p > 0.05). Steroid-induced intraocular hypertension was not observed in either group. CONCLUSIONS: A single posterior subtenon injection of TA can be as effective and safe as a 4-week regimen of prednisolone acetate 1% eyedrops in controlling intraocular inflammation after PPV.     

Ketorolac versus prednisolone versus combination therapy in the treatment of acute pseudophakic cystoid macular edema

OBJECTIVE: To evaluate the efficacy of ketorolac tromethamine 0.5% ophthalmic solution, prednisolone acetate 1.0% ophthalmic solution, and ketorolac and prednisolone combination therapy in the treatment of acute, visually significant, cystoid macular edema (CME) occurring after cataract extraction surgery. DESIGN: Randomized, double-masked, prospective trial. PARTICIPANTS: Twenty-eight patients who had undergone cataract extraction and in whom clinical CME developed within 21 to 90 days after cataract surgery. METHODS: Patients were randomized to topical therapy with ketorolac (group K), prednisolone (group P), or ketorolac and prednisolone combination therapy (group C) four times daily. Treatment was continued until CME resolved or for 3 months, whichever occurred first. Treatment was then tapered over 3 weeks. Examinations were monthly and included Snellen visual acuity, contrast sensitivity, Amsler grid, slit-lamp examination, dilated fundus examination, and fluorescein angiography. RESULTS: Twenty-six of 28 patients completed the study. Patients were enrolled an average of 48 days after surgery. The average improvements in Snellen visual acuity were as follows: 1.6 lines in group K, 1.1 lines in group P, and 3.8 lines in group C. This reached statistical significance for all visits when group C was compared with group P, and for visits 4 and 5 when group C was compared with group K. Group C reached a mean change of two lines or more by visit 2; at no time did either group K or P reach a mean two-line improvement. At no time was a significant difference detected between group K and P with regard to visual acuity or change from baseline. A two-line or more improvement in Snellen acuity was achieved in 16 of 26 patients (61%). Analysis by group revealed four of eight patients (50%) in group P, six of nine patients (67%) in group K, and eight of nine patients (89%) in group C who had achieved a two-line or more improvement. In patients who did improve two lines or more, improvement occurred an average of 2.75 months after initiating therapy in group P, 1.43 months in group K, and 1.33 months in group C. Improvements in contrast sensitivity and leakage on fluorescein angiography tended to mirror improvements in Snellen acuity. CONCLUSIONS: Treatment of acute, visually significant pseudophakic CME with ketorolac and prednisolone combination therapy appears to offer benefits over monotherapy with either agent alone. Patients were more likely to experience recovery of two lines or more of visual acuity. Patients treated with combination therapy or ketorolac monotherapy responded more quickly than did patients treated with prednisolone alone.     

The influence of topical corticosteroid therapy upon polymorphonuclear leukocyte distribution, vascular integrity and ascorbate levels in endotoxin-induced inflammation of the rabbit eye

An acute inflammatory response was initiated in the rabbit eye by an intravitreal injection of bacterial endotoxin. We examined the effect of topical corticosteroid therapy upon polymorphonuclear leukocyte (PMN) infiltration into the eye, protein leakage into aqueous humor and ascorbate level in aqueous humor. Corticosteroid therapy initiated prior to injection of endotoxin suppresses the clinical signs of inflammation, partially prevents the fall in aqueous-humor ascorbate level, has little effect upon protein leakage, but markedly reduces PMN infiltration. Corticosteroid therapy initiated after the injection of endotoxin also suppresses the clinical signs of inflammation, reduces the fall in ascorbate levels and does not influence protein leakage. However, in this case there is a marked persistence of PMN infiltration into ocular tissues. Thus the number of PMNs present in the ocular tissues is little different from that in non-steroid treated control eyes, although the clinical signs of inflammation are reduced. We suggest that in the clinical situation, the initial anti-inflammatory activity of the corticosteroids is related to an inhibitory effect upon the activity of PMNs already within the tissues, which then prevents the ensuing cascade of characteristic inflammatory events.     

Intraocular pressure elevation from topical difluprednate use

IntroductionDifluprednate ophthalmic emulsion 0.05% (Durezol?, Alcon, Fort Worth, Texas) is a topical difluorinated derivative of prednisolone with potent anti-inflammatory activity. Difluprednate 0.05% has a reported associated increase in intraocular pressure (IOP) in 3% of patients. Although the occurrence may be low, the possible elevation in IOP may be substantially higher than commonly encountered with other topical steroids.Case ReportsA 49-year-old black man presented with a traumatic anterior uveitis recalcitrant to traditional prednisolone acetate 1% treatment. The patient was switched to difluprednate 0.05% in an attempt to better control the ocular inflammation. Although the patient did not exhibit an IOP response after 4 weeks of treatment with prednisolone acetate 1%, he did experience a pressure response within 2 weeks of initiating difluprednate treatment, resulting in an IOP increase from 9 mmHg to 48 mmHg with subsequent microcystic edema.A 44-year-old black woman presented with recurrent scleritis resistant to topical prednisolone acetate, loteprednol etabonate, and oral nonsteroidal anti-inflammatory therapy. Topical loteprednol 0.5% was replaced by difluprednate 0.05%. All evidence of ocular inflammation was eradicated with the changed therapy. IOP rose in the difluprednate-treated eye from 18 mmHg to 34 mmHg over the course of 18 days. In both cases, the IOP elevation was managed rapidly with the discontinuation of difluprednate and temporary use of IOP-reducing agents with no lasting adverse effects.ConclusionDifluprednate 0.05% is a new topical therapeutic option indicated for the treatment of inflammation and pain management associated with ocular surgery with an off-label potential for treatment of other anterior segment inflammatory conditions. However, clinicians need to be aware of the potential risk for significant and potentially rapid onset of IOP increase with this medication and manage patients accordingly.     

Rimexolone 1% versus prednisolone acetate in preventing early postoperative inflammation after cataract surgery

Purpose: To compare the efficacy and safety of rimexolone 1% and prednisolone acetate 1% ophthalmic suspensions in controlling intraocular inflammation in the early period after cataract surgery. Methods: Eighty patients undergoing cataract extraction with intraocular lens implantation, either planned extra capsular cataract extraction (PECCE) or phacoemulsification surgery, were evaluated in a prospective, randomized, observer-masked, clinical trial in which efficacy in controlling early postoperative inflammation and safety of prednisolone acetate 1% one eye drop every 4 h (n = 36 eyes) was compared with that of rimexolone 1% one eye drop every 4 h (n = 44 eyes) in an eighteen day course. Efficacy was assessed from changes of the anterior chamber cell count, flare, conjunctival hyperemia, and ciliary congestion by means of slit lamp biomicroscopy on days 1, 3, 8, 15, and 18. Intraocular pressure (IOP) and possible side effects were also recorded on each visit. Results: Anterior chamber cell count and flare showed no difference in the two groups at any visits. The rimexolone group was associated with significantly higher score for conjunctival hyperemia on days one and three (P < 0.05) and the prednisolone acetate group was associated with a significantly higher score for corneal edema on day 8 (P < 0,05). However, there were no between group differences in IOP. Conclusions: Rimexolone 1% ophthalmic suspension was as effective and safe as prednisolone acetate 1% ophthalmic suspension in controlling inflammation in the early period after cataract surgery.     

Systemic toxicity of topical and periocular corticosteroid therapy in an 11-year-old male with posterior uveitis

PURPOSE: To report a case of systemic corticosteroid toxicity resulting from topical and periocular therapy. METHODS: Treatment and follow-up of an 11-year-old male with uveitis are illustrated. Initial presentation of the patient was bilateral iridocyclitis, for which he was treated with prednisolone acetate 1% every 2 hours for 6 months. Subsequently, posterior uveitis developed, necessitating posterior subtenon injections. RESULTS: After initial topical corticosteroid therapy, the patient developed a cushingoid habitus accompanied by increased lanugo hair, acanthosis nigricans, posterior subcapsular lens opacities, and increased intraocular pressure. Cushingoid stigmata worsened after administration of posterior subtenon injection of corticosteroids. The patient's truncal obesity worsened, and his linear growth stopped. CONCLUSIONS: Systemic toxic effects may develop as a result of topical and local use of ophthalmic corticosteroid preparations in susceptible patients.     

Treatment of ocular inflammatory conditions with loteprednol etabonate

Ocular inflammatory diseases impose a significant medical and economic burden on society. Corticosteroids are potent anti-inflammatory agents that have been used successfully to treat ocular inflammation. Topical corticosteroids provide maximal drug delivery, and are used to reduce the signs and symptoms of intraocular and ocular surface inflammation. However, side effects associated with topical corticosteroids-including increased intraocular pressure, risk of cataract formation after long-term use, and decreased resistance to infection-are concerns. Loteprednol etabonate (LE) is an ester corticosteroid with a high therapeutic index that contains an ester, rather than a ketone, at carbon-20 of the prednisolone core structure. LE blocks the release and action of inflammatory mediators and is clinically effective in the treatment of steroid-responsive inflammatory conditions including giant papillary conjunctivitis, seasonal (intermittent) allergic conjunctivitis and uveitis. LE relieves ocular surface and lacrimal gland inflammation associated with dry eye and is used in combination with ciclosporin A as a treatment of dry eye. LE is also effective in the treatment of postoperative ocular inflammation. Because of its rapid de-esterification to inactive metabolites, LE appears to have an improved safety profile compared with ketone corticosteroids, and may be more suitable than ketone corticosteroids for the treatment for ocular inflammatory conditions in which long-term therapy is necessary. However, further comparative safety studies are needed.     

Clinical outcome of chronic immunosuppression in patients with non-infectious uveitis

AIM: To determine the visual outcome and corticosteroid dose requirement in patients with non-infectious uveitis affecting the posterior segment treated with corticosteroids and additional second-line immunosuppression. METHOD: A retrospective, non-comparative case series was carried out. Seventy-two patients (141 eyes) with uncontrolled non-infectious uveitis on systemic prednisolone were treated with at least one second-line immunosuppressive agent in addition to systemic prednisolone and followed for at least 3 months.Visual acuity (VA), clinical disease activity, corticosteroid-sparing effect, disease relapses requiring corticosteroid dose increase,and side-effects from second-line agents were evaluated. RESULTS: At the end of the follow-up period (mean: 55.5 months),70 eyes (49.6%) had VA of 6/9 or better. There was a reduction in the mean maintenance dose of prednisolone required before the introduction of the second-line agent (19 mg/day +/- 2 SE)when compared to the mean maintenance dose of prednisolone at the end of the data collection (9 mg/day +/- 1 SE; P <0.001).There was also a significant reduction in the number of disease relapses requiring an increase in prednisolone dose after starting the second-line agents as compared to the year before (P <0.02). CONCLUSION: In patients with uveitis affecting the posterior segment, the addition of all second-line immunosuppressive therapy was effective in allowing reduction of the dose of systemic prednisolone to 10 mg/day or less, in controlling intraocular inflammation, reducing the number of relapses and in maintaining vision. Because of their side-effects, immunosuppressive treatment should be individualized and monitored closely but its addition is beneficial in the short and longer term.     

Efficacy of antifungal agents in the cornea. II. Influence of corticosteroids

The influence of topical corticosteroid on the efficacy of five topical antifungal agents was evaluated in a standardized rabbit model of Candida keratitis using a quantitative mycologic technique. Topical 1% prednisolone acetate worsened the disease when given alone and adversely influenced the efficacy of 5% natamycin, 1% flucytosine, and 1% miconazole when given in combination. The efficacy of amphotericin B appeared unaffected when the antifungal agent was administered in concentrations of 0.5% and 0.15%. The adverse effect of the topical corticosteroid appeared to be inversely related to the efficacy of the antifungal agent in vivo.     

Comparison of the efficacy and safety of ketorolac tromethamine 0.5% and prednisolone acetate 1% after cataract surgery.

PURPOSE: To compare the anti-inflammatory and analgesic efficacy and safety of ketorolac tromethamine 0.5% ophthalmic solution with those of prednisolone acetate 1% in patients having cataract surgery. SETTING: Shawnee Mission Eye Care, Shawnee Mission, Kansas, USA. METHODS: This double-blind, randomized, single-site study comprised 59 healthy men and women with a clinical diagnosis of routine ocular cataract requiring surgical removal. All patients had extracapsular cataract extraction and posterior chamber intraocular lens implantation. After surgery, patients were randomized to receive ketorolac tromethamine 0.5% or prednisolone acetate 1%, self-instilled in the treated eye, according to the following schedule: 1 to 2 drops 4 times daily (week 1); 3 times daily (week 2); 2 times daily (week 3); once daily (week 4). Patients were examined postoperatively on days 1, 7, and 28. Intraocular anti-inflammatory efficacy was assessed by lid edema, lid injection, conjunctival injection, corneal edema, ciliary flush, and anterior chamber cells. Analgesic efficacy was assessed by patient self-rated pain severity, pain frequency, total symptom sum, and overall global improvement. RESULTS: Both treatments produced comparable reductions in intraocular inflammation and pain after cataract surgery and were well tolerated by patients. No adverse events were reported, and there were no significant changes in intraocular pressure in either group. Improvements in visual acuity were also similar in both groups. CONCLUSION: Ketorolac tromethamine 0.5% ophthalmic solution was as effective and well-tolerated as prednisolone acetate 1% solution in controlling postoperative inflammation and pain after cataract surgery.     

Treatment of herpes simplex virus stromal keratitis unresponsive to topical prednisolone 1% with topical cyclosporine 0.05%

PURPOSE: To assess the efficacy of topical cyclosporine 0.05% (Restasis) in patients with herpes simplex virus nonnecrotizing stromal keratitis unresponsive to topical prednisolone. DESIGN: Prospective case series. METHODS: Patients with herpes simplex virus stromal keratitis (n = 12) that was unresponsive to topical prednisolone acetate 1% for at least four weeks were evaluated at a single site. Eyes were treated with topical cyclosporine twice a day and begun on a rapid prednisolone taper. Visual acuity, slit-lamp appearance, intraocular pressure, and corneal sensitivity were evaluated every two weeks for at least three months. RESULTS: Stromal keratitis resolved with cyclosporine in 10 of 12 patients after one month. The mean lesion area decreased more with cyclosporine than with prednisolone (2.0 mm with cyclosporine compared with 0.25 mm with prednisolone). After stopping cyclosporine therapy, four patients had recurrence of stromal keratitis. CONCLUSION: This series suggests that herpes simplex virus stromal keratitis can be treated effectively with topical cyclosporine, particularly in cases that are not responsive to topical prednisolone.     

Combined topical fluconazole and corticosteroid treatment for experimental Candida albicans keratomycosis

PURPOSE: To determine the most efficient time point and concentration of topical corticosteroids in Candida albicans keratitis treated with fluconazole. METHODS: Corneas of 105 rabbits were infected with viable yeast cells of C. albicans (2.5 x 10(5)). After a 48-hour incubation period, seven groups of animals were treated for 21 days with fluconazole, with group I acting as a control, and groups II to VII receiving adjunct therapy with the corticosteroid prednisolone (5 or 10 times daily; 3, 9, or 15 days after infection). The degree of corneal infiltration, ulceration, corneal clouding, hypopyon, conjunctivitis, neovascularization, and corneal perforation was monitored over a 24-day period, as well as recultivation and resistance to fluconazole of the C. albicans pathogen. RESULTS: The control group showed the highest level of corneal clouding and neovascularization. In comparison, by day 24, the majority of groups also treated with prednisolone displayed significantly less corneal clouding and neovascularization. An immediate decrease in corneal clouding was observed in groups treated with additional low- or high-dose prednisolone from day 9 after inoculation. After additional prednisolone treatment from day 9 or 15 after inoculation, no significant difference was detected in the recultivation rate of C. albicans compared with the control. Early administration of prednisolone (day 3, low and high dose) resulted in the recultivation of significantly more C. albicans. CONCLUSIONS: Fluconazole plus adjunct high-dose prednisolone treatment was most effective when administered 9 days after infection. The delayed application of corticosteroids after treatment with antimycotic drugs in cases of fungal keratitis is therefore not contraindicated and may be beneficial in patients.     

The efficacy of hyperbaric oxygen for the treatment of experimental uveitis induced in rabbits

OBJECTIVE: The aim of the present study was to examine the efficacy of hyperbaric oxygen (HBO) therapy in the treatment of experimental uveitis induced in rabbits. It was hypothesized that HBO therapy improves the regression of experimental uveitis induced in rabbits. RESEARCH DESIGN AND METHODS: An experimental animal study was conducted on 48 rabbits (48 right eyes of these rabbits) to evaluate the effects of HBO therapy on endotoxin-induced acute anterior uveitis in rabbits. To induce acute anterior uveitis, Salmonella typhimurium lipopolysaccharide endotoxin (LPS) was intravitreally injected into the right eyes of the rabbits. The animals were randomly assigned to five groups. No treatment was given to the rabbits in Group A. Prednisolone acetate was topically administered to the rabbits in Group B. Methylprednisolone acetate was administered by anterior subtenon injection to the rabbits in Group C four hours after LPS application. HBO therapy was administered to the rabbits in Group D. Both HBO therapy and anterior subtenon injection of methylprednisolone therapy were administered to the rabbits in Group E. To compare the effects of the different therapies on the progression of endotoxin-induced uveitis, examinations including clinical scoring of anterior uveitis, microscopic examination of aspirated aqueous humor for inflammatory responses, and aqueous protein level assessment were performed once a day after LPS injection. RESULTS: There was a statistically significant difference between the control group (Group A) and other groups (Groups B-E) with respect to the number of inflammatory cells and protein levels in the aqueous one and three days after LPS injection (p < 0.05), indicating that the treatments resulted in less inflammation in Groups B-E compared to Group A. Moreover, there was no statistically significant difference between Groups B and C, Groups B and D, Groups B and E, Groups C and D, and Groups C and E with regard to the number of inflammatory cells in the aqueous at Day 1 after LPS injection (p > 0.05). In addition, Groups B and C and Groups B and D were comparable with regard to cell counts at Day 3 (p > 0.05), showing that HBO was comparable to corticosteroids in reducing inflammation. The differences between Groups B and E and Groups C and E were significant with regard to aqueous cell counts at Day 3 (p < 0.05), showing that HBO plus steroid was more effective than steroids alone. CONCLUSION: The intensity of ocular inflammation in the group receiving HBO therapy combined with anterior subtenon injection of methylprednisolone therapy was lower than in the other groups. We also demonstrated that HBO therapy was an effective therapeutic modality for the treatment of experimental uveitis induced in rabbits with an efficacy comparable to that of corticosteroids. Moreover, HBO plus steroid was superior to steroids alone in reducing inflammation.