Saran B R, Maguire A M
Retina Service, Scheie Eye Institute, Philadelphia, Pennsylvania 19104.
Retina. 1994;14(3):248-52. doi: 10.1097/00006982-199414030-00010.
Intravitreal administration of ganciclovir has been used to treat cytomegalovirus (CMV) retinitis in patients with acquired immune deficiency syndrome (AIDS) who are unable to tolerate systemic antiviral therapy. Although retinal toxicity from intravitreal ganciclovir has been observed in animal experiments, to our knowledge, retinal toxicity from intravitreal ganciclovir has not been reported in humans.
A case of inadvertent intravitreous injection of a high dose of ganciclovir (40 mg/0.1 ml) for CMV retinitis in a patient with AIDS is presented.
Despite immediate intervention with vitreous surgery, permanent retinal damage and visual loss developed. Clinical observations and photographic documentation are provided.
Retinal toxicity can occur from a high-dose intravitreal ganciclovir injection. This toxicity may result from the high alkaline nature of this preparation, from osmotic damage, or from a direct effect of the concentrated ganciclovir.
玻璃体内注射更昔洛韦已被用于治疗无法耐受全身抗病毒治疗的获得性免疫缺陷综合征（AIDS）患者的巨细胞病毒（CMV）视网膜炎。尽管在动物实验中已观察到玻璃体内注射更昔洛韦会产生视网膜毒性，但据我们所知，尚未有人类因玻璃体内注射更昔洛韦而出现视网膜毒性的报道。
报告了1例AIDS患者因CMV视网膜炎意外玻璃体内注射高剂量更昔洛韦（40mg/0.1ml）的病例。
尽管立即进行了玻璃体手术干预，但仍出现了永久性视网膜损伤和视力丧失。提供了临床观察和照片记录。
高剂量玻璃体内注射更昔洛韦可导致视网膜毒性。这种毒性可能是由于该制剂的高碱性、渗透损伤或浓缩更昔洛韦的直接作用所致。
