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Gentamicin toxicity in the primate retina.
B P Conway1, C A Tabatabay, P A Campochiaro
1Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville 22908.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|January 1, 1989
Summary
Intravitreal gentamicin sulfate caused retinal damage in primates, affecting inner retinal layers. This neurotoxic effect, observed at high doses, suggests potential blood flow shutdown, though the safe clinical dose requires further study.
Area of Science:
- Ophthalmology
- Toxicology
- Neuroscience
Background:
- Aminoglycoside antibiotics, like gentamicin, are used to treat infections.
- Intravitreal injections are a route for delivering medication directly to the eye.
- Potential toxicity of intravitreal gentamicin in the primate retina requires investigation.
Purpose of the Study:
- To investigate the toxic effects of gentamicin sulfate on the primate retina following intravitreal injection.
- To characterize the histopathological changes induced by gentamicin in the retina.
- To explore the potential mechanisms underlying gentamicin-induced retinal damage.
Main Methods:
- Gentamicin sulfate was intravitreally injected into Cebus navrigatus monkeys.
- Fundus examination and fluorescein angiography were performed.
- Light and electron microscopy were used to examine retinal tissue.
Main Results:
- High doses (1000-3000 microgram) of intravitreal gentamicin caused apparent macular infarction.
- Damage was primarily observed in the inner retinal layers (nerve fiber, ganglion cell, inner plexiform, inner nuclear layers).
- No primary vascular lesions were identified, suggesting a neurotoxic mechanism possibly involving granulocytic plugging.
Conclusions:
- Intravitreal gentamicin exhibits neurotoxic effects on the primate retina at high doses.
- The observed retinal damage may result from a shutdown of regional blood flow.
- Further research is needed to definitively establish a safe dose for clinical intravitreal gentamicin use.