Ocular toxicity of iontophoretic foscarnet in rabbits

Transscleral iontophoresis of foscarnet is a noninvasive drug delivery system for the local treatment of cytomegalovirus (CMV) retinopathy. We determined the retinotoxic effects of transscleral iontophoresis of foscarnet. Slit-lamp biomicroscopy revealed no toxic effects for any of the treated eyes. Indirect ophthalmoscopy showed retinal and choroidal burns 1-3 mm in diameter at the site of iontophoresis in both foscarnet-treated eyes and saline-treated control eyes. Light and electron microscopy revealed focal retinal, retinal pigment epithelial, and choroidal necrosis at the site of iontophoresis but no abnormalities elsewhere. Ganzfeld electroretinographic studies revealed no response differences between foscarnet-treated eyes vs. controls.