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Gao H, Pennesi ME, Shah K, et al. Intravitreal Voriconazole: An Electroretinographic and Histopathologic Study. Arch Ophthalmol. 2004;122(11):1687–1692. doi:10.1001/archopht.122.11.1687
Voriconazole, a novel triazole antifungal agent, presents potent activityagainst a broad spectrum of yeast and molds.
To determine whether voriconazole could be safely used as an intravitrealagent in the treatment of fungal endophthalmitis.
Retinal toxicity of voriconazole was examined in a rodent animal model.Voriconazole solutions were serially diluted and injected intravitreally intothe eyes of normal adult Sprague-Dawley rats so that the final intravitrealconcentrations were 5 μg/mL, 10 μg/mL, 25 μg/mL, 50 μg/mL, and500 μg/mL (n = 3 for each concentration group). Saline was injectedinto the fellow eyes of all animals as controls. Three weeks after injections,electroretinograms were measured, and eyes were subsequently enucleated forhistologic examination.
In electroretinographic studies, maximum scotopic b-wave, intensityneeded for half saturation, and saturated a-wave amplitude were measured.There was no statistically significant difference in these parameters recordedbetween control eyes and voriconazole-injected eyes in any concentration groups.Histologic examination with light microscopy did not reveal any retinal abnormalityin the eyes with 5 to 25 μg/mL of intravitreal voriconazole. In the eyeswith 50 μg/mL and 500 μg/mL of voriconazole, small foci of retinal necrosiswere occasionally observed in the outer retina, especially in the eyes with500 μg/mL of voriconazole.
Our results demonstrate that intravitreal voriconazole of up to 25 μg/mL causes no electroretinographic change or histologic abnormality in rat retinas.This indicates that voriconazole is a safe antifungal agent for intravitrealinjection in rodents and may be used in the treatment of human fungal endophthalmitisfollowing further study.