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December 1992

Intravitreal Aminoglycoside Toxicity Revisited-Reply

Author Affiliations

Baltimore, Md
Charlottesville, Va

Arch Ophthalmol. 1992;110(12):1684-1685. doi:10.1001/archopht.1992.01080240021011

In Reply.  —We thank Dr Pulido et al for their valuable comments concerning aminoglycoside toxicity. We agree with their premise that, like most biologic phenomena, drug toxicity has a certain amount of variability among individuals. We also agree that their evaluation of the data of Zachary and Forster suggests that the above premise applies to retinal toxicity from intravitreous aminoglycosides and supports the contention that doses of gentamicin sulfate previously considered safe might be toxic in some individuals.We would, however, like to offer a note of caution. While the operating premise of Dr Pulido et al is valid and their analysis is appropriate, it should be noted that any recommendation concerning drug toxicity to the retina obtained from animal experiments is a rough estimate. Species differences are likely to be more important sources of uncertainty in determining safe and toxic doses than are methods of data analysis. Trivial differences

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