Toxicity of Intraocular Gentamicin

Macular ischemia after intravitreal amikacin on patient with intraocular foreign body

“…Cases of macular infarction secondary to administration of intraocular aminoglycosides have been observed after excessive intraocular doses while others have occurred after normal use [9]. There are several potentially toxic antibiotics in the aminoglycoside family including tobramycin and amikacin, with gentamicin having the greatest toxicity profile [10].…”

“…Following concerns about the risks of retinal toxicity caused by intravitreal gentamicin, many ophthalmologists now prefer intravitreal amikacin even though its use has also been associated with retinal toxicity [11]. Massive doses may result in early superficial and intraretinal hemorrhages, retinal edema, cotton wool patches, arterial narrowing, and venous beading [9]. In our patient, on the first day following IOFB extraction and IVAB injection we noted sudden decreased VA with the posterior segment examination revealing macular ischemia.…”

Macular ischemia after intravitreal amikacin on patient with intraocular foreign body

“…Cases of macular infarction secondary to administration of intraocular aminoglycosides have been observed after excessive intraocular doses while others have occurred after normal use [9]. There are several potentially toxic antibiotics in the aminoglycoside family including tobramycin and amikacin, with gentamicin having the greatest toxicity profile [10].…”

“…Following concerns about the risks of retinal toxicity caused by intravitreal gentamicin, many ophthalmologists now prefer intravitreal amikacin even though its use has also been associated with retinal toxicity [11]. Massive doses may result in early superficial and intraretinal hemorrhages, retinal edema, cotton wool patches, arterial narrowing, and venous beading [9]. In our patient, on the first day following IOFB extraction and IVAB injection we noted sudden decreased VA with the posterior segment examination revealing macular ischemia.…”

Treatment and Outcome of Traumatic Endophthalmitis in Open Globe Injury with Retained Intraocular Foreign Body

“…In a recent randomized clinical trial, intravitreal clindamycin and gentamicin were effective in the prevention of acute posttraumatic bacterial endophthalmitis in eyes with RIOFB [24]. However, the retinal toxicity of intraocular gentamicin still is a major concern of most ophthalmologists [25, 26]. In the current study, we recommend that eyes with traumatic endophthalmitis should be given broad-spectrum intravitreal antibiotics vancomycin (1.0 mg/0.1 ml) in combination with ceftazidime (2.25 mg/0.1 ml) (or amikacin 400 ug/0.1 ml) [27, 28].…”

Macular ischemia after intravitreal amikacin on patient with intraocular foreign body

“…Cases of macular infarction secondary to administration of intraocular aminoglycosides have been observed after excessive intraocular doses while others have occurred after normal use [9]. There are several potentially toxic antibiotics in the aminoglycoside family including tobramycin and amikacin, with gentamicin having the greatest toxicity profile [10].…”

“…Following concerns about the risks of retinal toxicity caused by intravitreal gentamicin, many ophthalmologists now prefer intravitreal amikacin even though its use has also been associated with retinal toxicity [11]. Massive doses may result in early superficial and intraretinal hemorrhages, retinal edema, cotton wool patches, arterial narrowing, and venous beading [9]. In our patient, on the first day following IOFB extraction and IVAB injection we noted sudden decreased VA with the posterior segment examination revealing macular ischemia.…”

Treatment and Outcome of Traumatic Endophthalmitis in Open Globe Injury with Retained Intraocular Foreign Body

“…In a recent randomized clinical trial, intravitreal clindamycin and gentamicin were effective in the prevention of acute posttraumatic bacterial endophthalmitis in eyes with RIOFB [24]. However, the retinal toxicity of intraocular gentamicin still is a major concern of most ophthalmologists [25, 26]. In the current study, we recommend that eyes with traumatic endophthalmitis should be given broad-spectrum intravitreal antibiotics vancomycin (1.0 mg/0.1 ml) in combination with ceftazidime (2.25 mg/0.1 ml) (or amikacin 400 ug/0.1 ml) [27, 28].…”

Macular ischemia after intravitreal amikacin on patient with intraocular foreign body

“…Cases of macular infarction secondary to administration of intraocular aminoglycosides have been observed after excessive intraocular doses while others have occurred after normal use [9]. There are several potentially toxic antibiotics in the aminoglycoside family including tobramycin and amikacin, with gentamicin having the greatest toxicity profile [10].…”

“…Following concerns about the risks of retinal toxicity caused by intravitreal gentamicin, many ophthalmologists now prefer intravitreal amikacin even though its use has also been associated with retinal toxicity [11]. Massive doses may result in early superficial and intraretinal hemorrhages, retinal edema, cotton wool patches, arterial narrowing, and venous beading [9]. In our patient, on the first day following IOFB extraction and IVAB injection we noted sudden decreased VA with the posterior segment examination revealing macular ischemia.…”

Treatment and Outcome of Traumatic Endophthalmitis in Open Globe Injury with Retained Intraocular Foreign Body

“…In a recent randomized clinical trial, intravitreal clindamycin and gentamicin were effective in the prevention of acute posttraumatic bacterial endophthalmitis in eyes with RIOFB [24]. However, the retinal toxicity of intraocular gentamicin still is a major concern of most ophthalmologists [25, 26]. In the current study, we recommend that eyes with traumatic endophthalmitis should be given broad-spectrum intravitreal antibiotics vancomycin (1.0 mg/0.1 ml) in combination with ceftazidime (2.25 mg/0.1 ml) (or amikacin 400 ug/0.1 ml) [27, 28].…”