Aminoglycoside toxicity in the treatment of endophthalmitis. The Aminoglycoside Toxicity Study Group.

Abstract

Intravitreous aminoglycosides are widely used for the treatment and prophylaxis of endophthalmitis. Because the toxicity of 0.4 mg of gentamicin sulfate is well documented, many surgeons now use amikacin sulfate or low-dose gentamicin to reduce the risk of macular infarction. A survey of retinal specialists has suggested that amikacin or low-dose gentamicin can also cause macular toxic side effects. To further investigate this issue, the critical details of the case histories, findings, and course of 13 patients who received intravitreous injections of 0.2 to 0.4 mg of amikacin sulfate or 0.1 to 0.2 mg of gentamicin sulfate for prophylaxis or treatment of endophthalmitis are summarized. For several patients, complete case histories and a fluorescein angiogram are provided.