Evaluation of the Retinal Toxicity and Pharmacokinetics of Dexamethasone After Intravitreal Injection

doi:10.1001/archopht.1992.01080140115038

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Vol. 110 No. 2, February 1992

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Evaluation of the Retinal Toxicity and Pharmacokinetics of Dexamethasone After Intravitreal Injection

Hyung Woo Kwak, MD; Donald J. D'Amico, MD

Arch Ophthalmol. 1992;110(2):259-266.

Abstract

• The intravitreal injection of steroids may be potentiallyuseful in the treatment of endophthalmitis and other ocularinflammatory diseases. The retinal toxicity and intraocularturnover of aqueous solutions of dexamethasone sodium phosphatein doses ranging from 440 to 4000 µg were evaluated inthe rabbit; evaluation was also performed for a 0.1-mL injectionof a commercially available preparation (dexamethasone phosphate[Decadron] injection, 4 mg/mL). After the 440-µg dose,a transient increase in staining of the Müller cells wasobserved, which normalized after 2 days. Progressively higherdoses resulted in an increasing spectrum of disorganizationin Müller and other retinal cells. The half-life of theintravitreally injected drug was 3.48 hours. These findingssuggest a primary interference in Müller cell function,possibly through dexamethasoneinduced alterations in retinalglutamate or glucose metabolism.

Author Affiliations

From the Retina Service (Dr D'Amico) and the Howe Laboratory of Ophthalmology (Drs Kwak and D'Amico), Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston.

Footnotes

Accepted for publication August 16, 1991.

Reprint requests to Massachusetts Eye and Ear Infirmary, 243Charles St, Boston, MA 02114 (Dr D'Amico).

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