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To the Editor.
—I read with great interest the article entitled "Toxicity of Intravitreous Miconazole" by Tolentino et al in the September Archives (1982;100:1504-1509) and thought their study superb. Four years ago we evaluated the toxic effects of intravitreal miconazole nitrate (unpublished data) but were unable to demonstrate in vivo the efficacy of this drug in the management of experimental Candida albicans endophthalmitis. It would be important to know if these authors experienced similar problems. If so, caution should be used in advocating the intravitreal use of this drug. We have encountered similar problems with flucytosine and ketoconazole. While these drugs demonstrate satisfactory in vitro effects against fungi, for reasons unknown to us, their in vivo efficacy is minimal or nonexistent.
Gholam A. Peyman. Intravitreous Miconazole. Arch Ophthalmol. 1983;101(3):487. doi:10.1001/archopht.1983.01040010487040