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Macular infarction after intravitreal amikacin: mounting evidence against amikacin
  1. G Galloway,
  2. A Ramsay,
  3. K Jordan,
  4. A Vivian
  1. Department of Ophthalmology, West Suffolk Hospital, Bury St Edmunds, IP33 2QZ, UK
  1. Correspondence to: Mr Gavin Galloway; gavgal{at}

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Retinal toxicity attributable to intravitreal use of aminoglycosides for endophthalmitis has been reported. Campochiaro and Conway reported 101 cases of retinal damage due to intravitreal aminoglycosides.1 Amikacin, an aminoglycoside, is in widespread use in the United Kingdom for the treatment of Gram negative organisms in endophthalmitis. We report a case of macular toxicity following the use of intravitreal amikacin for postoperative endophthalmitis, outline mechanisms of retinal toxicity, and offer alternatives to amikacin. We believe that enough evidence now exists to support a change in the current Royal College of Ophthalmologists' endophthalmitis treatment guidelines that are based on the Endophthalmitis Vitrectomy Study.2

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