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Ординатура / Офтальмология / Английские материалы / Clinical Ocular Toxicology Drug-Induced Ocular Side Effects_Fraunfelder, Chambers _2008.pdf
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effects side ocular induced-Drug  • PART7  

with time. The injection of this agent subconjunctivally or subcutaneously can cause permanent yellowing. Some clinicians feel that amphotericin B is too toxic to the tissue to be given subconjunctivally­ . However, in extreme circumstances, even intracorneal injections have been done (Garcia-Vlaenzuela and Song 2005).

References and Further Reading

Bell RW, Ritchey JP. Subconjunctival nodules after amphotericin B injection. Arch Ophthalmol 90: 402–404, 1973.

Brod RD, Flynn HW, Clarkson JG, et al. Endogenous candida endophthalmitis. Management without intravenous amphotericin B. Ophthalmology 97: 666–674, 1990.

Doft BH, et al. Amphotericin clearance in vitrectomized versus nonvitrectomized eyes. Ophthalmology 92: 1601, 1985.

Foster CS, et al. Ocular toxicity of topical antifungal agents. Arch Ophthalmol 99: 1081, 1981.

Garcia-Valenzuela E, Song D. Intracorneal injection of amphotericin B for recurrent fungal keratitis and endophthalmitis. Arch Ophthalmol 123: 1721–1723, 2005.

Li PKT, Lai KN. Amphotericin B-induced ocular toxicity in cryptococcal meningitis. Br J Ophthalmol 73: 397–398, 1989.

Lavine JB, Binder PS, Wickham MG. Antimicrobials and the corneal ­endothelium. Ann Ophthalmol 11: 1517, 1979.

O’Day DM, et al. Intraocular penetration of systemically administered antifungal agents. Curr Eye Res 4: 131, 1985.

O’Day DM, Smith R, Stevens JB. Toxicity and pharmacokinetics of subconjunctival amphotericin B. Cornea 10(5): 411–417, 1991.

Generic name: Griseofulvin.

Proprietary name: Gris-PEG, Grisfulvin V.

Conditional/Unclassified

1. Macular edema (transient)

2. Systemic lupus erythematosis

3. Superficial corneal opacities

4. Color vision defect

Clinical significance

Systemic griseofulvin rarely causes ocular side effects, but severe allergic reactions with secondary ocular involvement may occur. Decreased vision rarely occurs and seldom requires stopping the drug except in cases of intracranial hypertension. Delman and Leubuscher (1963) reported a single case of unilateral, greenish vision with transient macular edema possibly secondary to this agent. There is a case of bilateral superficial corneal deposits resembling Meesman’s corneal dystrophy with ocular injection and superficial punctate keratitis which was reported to the National Registry that resolved within 1 week after discontinuation of the drug. This agent is a photosensitizing drug, and increased light exposure increases the prevalence of eyelid and conjunctival reactions.

References and Further Reading

Alarcón-Segovia D. Drug-induced antinuclear antibodies and lupus syndromes­ . Drugs 12: 69, 1976.

Delman M, Leubuscher K. Transient macular edema due to griseofulvin. Am J Ophthalmol 56: 658, 1963.

Epstein JH, Wintroub BU. Photosensitivity due to drugs. Drugs 30: 41, 1985.

Madhok R, et al. Fatal exacerbation of systemic lupus erythematosus after treatment with griseofulvin. BMJ 291: 249, 1985.

Spaeth GL, Nelson LB, Beaudoin AR. Ocular teratology. in Jakobiec FA, Ocular Anatomy, Embryology and Teratology. JB Lippincott, Philadelphia, 1982, p 955-975.

Primary use

This oral antifungal agent is effective against tinea infections of

the nails, skin and hair. Generic name: Voriconazole.

Ocular side effects

Systemic administration

Certain

1. Decreased vision

2. Visual hallucinations

3. Eyelids or conjunctiva

a.Allergic reactions

b.Hyperemia

c.Edema

d.Photosensitivity

e.Angioedema

f.Urticaria

Probable

1. Papilledema secondary to intracranial hypertension

Possible

1. Subconjunctival or retinal hemorrhages secondary to drug-induced anemia

2. Eyelids or conjunctiva

a.Lupoid syndrome

b.Exfoliative dermatitis

c.Erythema multiforme

Proprietary name: Vfend.

Primary use

This is a new triazole antifungal agent given both orally and ­intravenously. Its greatest use is in aspergillosis infections.

Ocular side effects

Systemic administration

Certain

1. Altered or enhanced visual perception

2. Blurred vision

3. Photophobia

4. Decreased color vision

5. Visual hallucinations

6. ERG abnormalities

7. Eyelids or conjunctiva

a. Photosensitivity reactions

Possible

1. Eyelids or conjunctiva

a.Erythema multiforme

b.Stevens-Johnson syndrome

c.Toxic epidermal necrolysis

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