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Retinal toxicity of antibiotics: evaluation by electroretinogram
K Mochizuki1, M Torisaki, K Kawasaki
1Department of Ophthalmology, Kanazawa University, Japan.
Documenta Ophthalmologica. Advances in Ophthalmology
|June 1, 1988
Summary
Intravitreal gentamicin, sulbenicillin, and cefazolin showed varying retinal toxicity in rabbits. Recommended clinical doses aim to minimize electroretinogram damage, with gentamicin being the most toxic.
Area of Science:
- Ophthalmology
- Pharmacology
- Toxicology
Background:
- Intravitreal antibiotics are crucial for treating endophthalmitis.
- Assessing the retinal toxicity of commonly used antibiotics is essential for safe clinical application.
Purpose of the Study:
- To investigate the retinal toxicity of intravitreal gentamicin sulfate, disodium sulbenicillin, and cefazolin sodium.
- To determine safe dosage recommendations for these antibiotics based on electroretinogram (ERG) findings in rabbits.
Main Methods:
- Electroretinograms (ERGs) were recorded in albino and pigmented rabbits before and at multiple time points after intravitreal antibiotic injections.
- The effects of different doses of gentamicin, sulbenicillin, and cefazolin on ERG components (a-wave, b-wave, oscillatory potentials) were analyzed.
Main Results:
- Gentamicin (0.24 mg/0.1 ml) caused irreversible abolition of all ERG components.
- Sulbenicillin (4.0-12 mg/0.1 ml) dose-dependently suppressed the b-wave and oscillatory potentials transiently.
- Cefazolin (0.5-5.0 mg/0.1 ml) selectively reduced oscillatory potentials with recovery within 14 days, sparing a- and b-waves.
Conclusions:
- Gentamicin exhibits significant irreversible retinal toxicity at the tested dose.
- Sulbenicillin and cefazolin show dose-dependent and selective retinal effects, respectively.
- Recommended intravitreal doses are gentamicin 0.1 mg/0.1 ml, sulbenicillin 2 mg/0.1 ml, and cefazolin 0.25 mg/0.1 ml to minimize retinal toxicity.