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Aline Yoshie Goto, Andre Liber, Beatriz Sayuri Takahashi, Francisco Max Damico, Dora Fix Ventura, Christina Joselevitch; Morphological effects of the intravitreal injection of acyclovir upon cell density in the ganglion cell layer of the rabbit retina. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1545.
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© ARVO (1962-2015); The Authors (2016-present)
Acute retinal necrosis (ARN) is a very rapid and devastating viral retinitis. Intravenous acyclovir is the first line therapy for ARN due to its good selectivity against the etiological agents. During the first two days of treatment, while systemically administered acyclovir has not yet reached therapeutic levels in the retina, intravitreal injection of acyclovir might be used an adjuvant therapy. This study evaluated the impact of intravitreal injection of different doses of acyclovir on cell density in the ganglion cell layer of the retina, since this layer is the most exposed to the drug.
Retinas of 24 Dutch Belted rabbits were fixed and stained by the Nissl technique and cell density in the ganglion cell layer was sampled photographically and counted along the dorsoventral and nasotemporal axes. Animals were divided in groups of 6, according to the dose of acyclovir injected in the vitreous of the right eye (0.1, 1, and 10 mg, or sham injection). Left eyes received intravitreal injection of saline as control.
None of the doses used in this study led to a decrease in cell density in the areas sampled for counting. Nonetheless, the highest dose used (10 mg) induced the formation of holes in the peripheral retina and disorganization of the retinal layers in these areas.
These results suggest that intravitreally administered acyclovir does not cause cell death in the lowest doses used, but can be toxic to the retina at the highest dose. The morphological evidence obtained here confirms our previous findings showing that retinal function measured by the ERG was not affected by intravitreal injection of acyclovir in the same doses. The intravitreal injection of acyclovir may be an important tool in the treatment of ARN, as it allows immediate access of the drug to the retina and immediate onset of action.
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