Does ganciclovir exert retinal toxicity after multiple continuous intravitreal injections?

Abstract

Background The objective of this study is to report a case of acute retinal necrosis in which abnormalities in visual function did not correspond to retinal anatomical outcomes. Case presentation A 39-year-old female diagnosed with acute retinal necrosis underwent repeated (nine rounds) intravitreal ganciclovir injection (3 mg/0.1 ml) into the left eye, one injection every 2 weeks. During the therapy, the patient noticed her visual acuity declining gradually. The best corrected visual acuity in the left eye was 20/33. The visual field showed massive visual damage. There was no posterior necrotizing involvement, no macular edema or exudation, and only slight abnormity of the interdigitation zone in the fovea area was visible on OCT. Angio-OCT revealed normal capillary density of three retinal capillary and choriocapillaris layers. The visually evoked potential was normal. The photopic single-flash response showed a declined amplitude of a-wave and b-wave. The amplitudes of photopic 30 Hz flicker were decreased. Multifocal electroretinography revealed macular dysfunction. Conclusion Ganciclovir-associated photoreceptor damage may induce abnormalities in retinal function in response to multiple continuous intravitreal ganciclovir injections at a relatively high dosage (3 mg/0.1 ml).

Correlations between APACHE-II score and pressure parameters of mechanical ventilation in patients with ARDS and their value in prognostic evaluation

“… 10 Additionally, the alveolar fluid clearance and apoptosis are abnormal, which leads to the decline of pulmonary ventilation function. 11 At present, there is no specific drug to improve the survival of ARDS patients, and the main treatment is general supportive care for severe diseases combined with key mechanical ventilation. 12 , 13 Therefore, the early prediction of ADRS severity and prognosis may be of great significance to improve the prognosis and reduce the mortality of patients.…”

Comparative Effects of Valganciclovir and Ganciclovir on the Congenital Cytomegalovirus Infection and Hearing Loss: A Randomized Controlled Trial

“…GCV has the chemical name of 9-(1, 3-dihydroxy-2-propoxymethyl) guanine, whose pharmacological effect is to phosphorylate GCV to trivalent phosphate in CMV-infected cells, thereby inhibiting viral DNA synthesis. However, GCV trivalent phosphate has a very slow metabolism in the body (10). Clinically, intravenous infusion with indwelling PICC tube is often used to improve drug utilization rate, while indwelling PICC tube is prone to infection, posing a threat to patients' health.…”

Antiviral drugs

“…A recent systemic review of 102 studies (25 human and 77 animal) assessing the long-term effects in subjects receiving a prophylactic dose of ganciclovir observed a correlation with spermatic toxic effects in those patients ( Jensen et al, 2021 ) [M]. Hu and colleagues describe a case report of a 39-year-old female where intravitreal ganciclovir was associated with photoreceptor damage which can lead to abnormal retinal function ( Hu et al, 2021 ) [A].…”