Macula toxicity after intravitreal amikacin.
BACKGROUND
Although intravitreal aminoglycosides have substantially improved visual prognosis in endophthalmitis, macular infarction may impair full visual recovery.


METHODS
We present a case of presumed amikacin retinal toxicity following treatment with amikacin and vancomycin for alpha-haemolytic streptococcal endophthalmitis.


RESULTS
Endophthalmitis resolved with improvement in visual acuity to 6/24 at three months. Fundus fluorescein angiography confirmed macular capillary closure and telangiectasis.


CONCLUSIONS
Currently accepted intravitreal antibiotic regimens may cause retinal toxicity and macular ischaemia. Treatment strategies aimed at avoiding retinal toxicity are discussed.
Seawright
A A
AA
Retinal Service, Royal Brisbane Hospital, Queensland.
Bourke
R D
RD
Cooling
R J
RJ
D000293:Adolescent; D000583:Amikacin / Q000008:administration & dosage / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D007267:Injections; D007908:Lens, Crystalline / Q000601:surgery; D008266:Macula Lutea / Q000098:blood supply / Q000187:drug effects* / Q000473:pathology; D008297:Male; D012171:Retinal Vessels / Q000187:drug effects*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D013291:Streptococcus; D013684:Telangiectasis / Q000139:chemically induced* / Q000473:pathology; D014821:Vitrectomy; D014822:Vitreous Body / Q000187:drug effects*
D000900:Anti-Bacterial Agents; D000583:Amikacin