Retinal and Ocular Toxicity in Ocular Application of Drugs and Chemicals - Part II: Retinal Toxicity of Current and New Drugs

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dc.contributor.authorPenha, Fernando Marcondes [UNIFESP]
dc.contributor.authorRodrigues, Eduardo Buchele [UNIFESP]
dc.contributor.authorMaia, Mauricio [UNIFESP]
dc.contributor.authorFurlani, Bruno de Alburquerque [UNIFESP]
dc.contributor.authorRegatieri, Caio Vinicius Saito [UNIFESP]
dc.contributor.authorMelo, Gustavo Barreto de [UNIFESP]
dc.contributor.authorMagalhães, Octaviano [UNIFESP]
dc.contributor.authorManzano, Roberta [UNIFESP]
dc.contributor.authorFarah, Michel Eid [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T13:59:01Z
dc.date.available2016-01-24T13:59:01Z
dc.date.issued2010-01-01
dc.description.abstractAims: Retinal pharmacotherapy has gained great importance for the treatment of various retinal diseases. An increasing number of drugs have been constantly released into the market, especially for wet age-related macular disease and diabetic macular edema. in this review, the issues concerning the toxicity of current and new classes of drugs are discussed. Methods: An extensive search of the literature was performed to review various aspects of drug toxicity in retinal pharmacotherapy. the different major classes of drugs, such as corticosteroids, antibiotics, antimetabolites, antineoplastic agents, monoclonal antibodies (mAbs), nonsteroidal anti-inflammatory drugs, enzymes, fibrinolytics, miscellaneous anti-inflammatory and antiangiogenic agents, as well as toxicity unrelated to the drug were identified and discussed. Results: Corticosteroids like fluocinolone, dexamethasone or triamcinolone at low dose cause little damage to the retina, but at high doses signs of toxicity have been well documented. Complications like cataract and glaucoma are quite common with corticosteroids. Aminoglycosides showed differences in the type and doses associated with toxic reactions, thereby the following order of toxicity can be described (from most toxic to least toxic): gentamicin > netilmicin = tobramycin > amikacin = kanamycin. Vancomycin at the usual dose of 1 mg is not toxic to the retina, while further studies are necessary in order to clarify the safety of new-generation quinolones. 5-Fluorouracil has been shown to be nontoxic to the retina after an injection of 2.5 mg in animals. mAbs like ranibizumab and bevacizumab were demonstrated to be safe to the retina in cell culture, animals and humans at high doses. the exact biocompatibility of nonsteroidal anti-inflammatory agents like diclofenac needs further evaluation. Preservatives like benzyl alcohol and changes in pH or osmolarity exert an influence on the toxic effects of intravitreally applied drugs. Conclusions: A great number of drugs are now used mainly intravitreally without relevant retinal toxicity. Copyright (C) 2010 S. Karger AG, Baselen
dc.description.affiliationUniversidade Federal de São Paulo, Dept Ophthalmol, Vis Inst, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Ophthalmol, Vis Inst, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent205-224
dc.identifierhttp://dx.doi.org/10.1159/000316695
dc.identifier.citationOphthalmic Research. Basel: Karger, v. 44, n. 4, p. 205-224, 2010.
dc.identifier.doi10.1159/000316695
dc.identifier.issn0030-3747
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/32037
dc.identifier.wosWOS:000280932000001
dc.language.isoeng
dc.publisherKarger
dc.relation.ispartofOphthalmic Research
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.licensehttp://www.karger.com/Services/RightsPermissions
dc.subjectAvastinen
dc.subjectLucentisen
dc.subjectRetinaen
dc.subjectBevacizumaben
dc.subjectRanibizumaben
dc.subjectMonoclonal antibodiesen
dc.subjectTumor necrosis factoren
dc.subjectVascular endothelial growth factoren
dc.subjectCorticosteroidsen
dc.subjectAntimetabolitesen
dc.subjectTriamcinoloneen
dc.subjectNonsteroidal anti-inflammatory drugsen
dc.subjectMicroplasminen
dc.titleRetinal and Ocular Toxicity in Ocular Application of Drugs and Chemicals - Part II: Retinal Toxicity of Current and New Drugsen
dc.typeinfo:eu-repo/semantics/article
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