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J.E. Roberts, M. Rammal, F. Smith, M.G. Hamilton, C.F. Chignell; DETECTION AND PREVENTION OF OCULAR PHOTOTOXICITY OF CIPROFLOXACIN, THE PROPHYLACTIC ANTIDOTE FOR BIOTERRORISM–RELATED ANTHRAX. . Invest. Ophthalmol. Vis. Sci. 2004;45(13):389.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the potential ocular phototoxicity of Ciprofloxacin ("Cipro"), a prophylactic antidote for bioterrorism–related anthrax, and to compare the phototoxicity of this antibiotic with other fluoroquinoline antibiotics used for ocular infections. Methods: To determine if Cipro and other fluoroquinoline ocular antibiotics (enoxacin, lomefloxacin, nalidixic acid, norfloxacin and ofloxacin) would photooxidize cytosol lens proteins, α crystallin isolated from calf lenses was irradiated in the presence of the Ciprofloxacin or another fluoroquinolone (5 x 10–4 M, 10 mM ammonium bicarbonate, pH 7.0) in the presence of light that mimics corneal transmission (λ <300 nm, 12 mwatts/cm2). Photopolymerization of the lens protein was observed indicating potential phototoxicity. This was quantitatively assessed by scanning of SDS–PAGE. Binding of the antibiotic was determined by shifts in the UV spectrum of the drug. Results: All fluoroquinolines tested including Cipro absorbed light in the UV–A region (320–340 nm) and all photo–oxidized lens proteins. None of the drugs tested was found to bind to α crystallin. Conclusions: Ciprofloxacin, which is the drug currently being used prophylactically against bioterrorism–related anthrax, is potentially phototoxic to the eye. However, since neither Cipro nor the other fluoroquinolines bind to ocular proteins, permanent damage to the eye can be prevented. Patients must protect their eyes from intense sunlight by wearing wrap–around sunglasses designed to filter all light in the UVA and UVB regions while taking this medication.
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