J Korean Ophthalmol Soc > Volume 61(1); 2020 > Article
Journal of the Korean Ophthalmological Society 2020;61(1):111-115.
DOI: https://doi.org/10.3341/jkos.2020.61.1.111    Published online January 15, 2020.
Retinal Toxicity Following the Injection Ganciclovir into Silicone Oil-filled Eye to Treat Acute Retinal Necrosis.
Yeon Ji Jo, Seung Kwon Choi, Sun Ho Park, Jae Jung Lee, Ji Eun Lee, Sung Who Park
Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea. oph97@naver.com
실리콘기름 충전 급성망막괴사 눈에서 Ganciclovir 주입 후 발생한 망막독성
조연지 · 최승권 · 박선호 · 이재정 · 이지은 · 박성후
부산대학교 의과전문대학원 안과학교실
Correspondence:  Sung Who Park,
Email: oph97@naver.com
Received: 26 July 2019   • Revised: 4 September 2019   • Accepted: 30 December 2019
Abstract
PURPOSE
To report a case of retinal toxicity after an intravitreal ganciclovir injection to treat acute retinal necrosis in an eye filled with silicone oil. CASE SUMMARY: A 56-year-old male presented with ocular pain and visual loss in his right eye. His best-corrected visual acuity was 20/25, inflammatory cells in the anterior chamber, multiple retinitis lesions and retinal vessel occlusions in the peripheral retina and vitreous opacity were showed. Acute retinal necrosis was suspected, anterior chamber polymerase chain reaction (PCR) test was done. Aciclovir 2,400 mg/day intravenously and ganciclovir 2.0 mg were administered by intravitreal injection. After 4 days, retinitis was worsened and PCR test was positive for varicella zoster virus. Ganciclovir intravitreal injections were increased twice a week. After 16 days, retinal detachment occurred, so scleral encircling, vitrectomy, laser photocoagulation, and silicone oil tamponade were conducted. Ganciclovir 1.0 mg was injected at the end of surgery. The patient's visual acuity decreased to hand motion, and multiple crystal deposits with multiple retinal hemorrhages were observed in the right eye the next day. Visual acuity did not recover and optical coherent tomography showed that the macula was thinned. CONCLUSIONS: Visual loss seemed to be related with the retinal toxicity of ganciclovir. The increased local concentration due to the silicone oil tamponade is thought to have caused the toxicity.
Key Words: Ganciclovir;Retinal necrosis syndrome and acute;Retinal toxicity
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