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S Ebrahim, G Men, RC Metzinger, GA Peyman, DR Caldwell, P-C Kuo, F Ghahramani, K Holroyd; The Safety of Intravitreal Pexiganan . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4437.
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Purpose: Pexiganan is a new antimicrobial peptide of animal origin that exhibited broad-spectrum in vitro antibacterial activity. This study was conducted to evaluate the safety of intravitreal injections of Pexiganan for its potential use in the treatment of endophthalmitis. Methods: Sixteen New Zealand white rabbits were randomly divided into four groups. The right eyes were injected intravitreally with 5, 10, 50, and 100 µg of Pexiganan (Genaera Inc., Plymouth Meeting, PA) in 0.1 ml of 5% dextrose solution. The left eyes served as controls and received the volumetric equivalent dose of balanced salt solution injections. Retinal function was evaluated with electroretinography (ERG) tests before and after the injection. Follow-up procedures included slit-lamp biomicroscopy, indirect ophthalmoscopy, and anterior segment photography. Results: Lens opacities of variable degrees were observed in 75% of the eyes that received 5 µg of Pexiganan, and in 100% of the remaining eyes that received higher concentrations. No finding consistent with retinal toxicity was detected on ERG, funduscopy, or histopathology. The lens changes observed in this study varied from vesicle-like changes on the posterior lens capsule to posterior subcapsular cataract. Regression of the lens opacification was observed in 44% of the eyes. The density of these opacifications demonstrated a dose-related pattern. A slight intravitreal inflammatory reaction was observed in all experiment eyes. No control eyes showed similar changes. Conclusion: Although lens opacifications were observed with intravitreal injections of 5 µg or higher concentrations of Pexiganan, no finding consistent with retinal toxicity was determined in this study. Pexiganan may be useful in the treatment of postcataract extraction endophthalmitis.
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