Intraocular drug delivery into silicone oil-filled eyes

Experience with cidofovir (HPMPC)

F. M. Rahhal, I. Taskintuna, J Fernando Arevalo, A. Banker, T. Clarke, W. R. Freeman

Research output: Contribution to journalArticle

Abstract

Purpose. The management of vitreoretinal diseases, such as CMV retinitis, with local pharmacologic therapy is complicated in the setting of silicone oil vitreous substitute. We have previously shown that intravitreal cidofovir is effective in the treatment of CMV retinitis and undertook this pilot study to evaluate the feasibility and efficacy of these injections in eyes filled with silicone oil. Methods. We performed 12 intraocular injections of 10ug of cidofovir in seven oil-filled eyes of six patients with CMV retinitis. The 10ug dose (half the dose previously used) was chosen because of the small volume of ocular fluid in silicone filled eyes. Injections were performed through the pars plana into the middle of the silicone oil bubble. The spherical aqueous bubble could immediately be visualized within the oil using indirect ophthalmoscopy. Eyes were examined every two weeks. None of the patients were on any other type of systemic anti-CMV therapy during the entire study period. Results. Of the eight injections (in four eyes) which had adequate follow-up, seven (87.5%) resulted hi healing of the retinitis. Median time to progression after a single injection in eyes with active retinitis was 56 days. There were no cases of iritis, hypotony, or retinal redetachment with the 10ug dose. One eye had the aqueous bubble of cidofovir still undissolved in the silicone oil at the initial follow-up visit, at which time the retinitis remained active. The bubble was mechanically moved into the aqueous phase with a 27g needle and the retinitis then went on to heal without additional treatment. Conclusions. Intraocular injections directly into a silicone oil bubble can be easily and safely performed. Treatment of CMV retinitis by injecting lower-dose cidofovir with this technique appears to be safe and effective. These findings may have implications for the treatment of other vitreoretinal diseases in the presence of non-aqueous tamponading agents, including proliferative vitreoretinopathy.

Original languageEnglish (US)
JournalInvestigative Ophthalmology and Visual Science
Volume37
Issue number3
StatePublished - Feb 15 1996

Fingerprint

Silicone Oils
Retinitis
Pharmaceutical Preparations
Intraocular Injections
Injections
Oils
Therapeutics
Iritis
Proliferative Vitreoretinopathy
Ophthalmoscopy
Temazepam
cidofovir
Silicones
Disease Management
Needles

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Intraocular drug delivery into silicone oil-filled eyes : Experience with cidofovir (HPMPC). / Rahhal, F. M.; Taskintuna, I.; Arevalo, J Fernando; Banker, A.; Clarke, T.; Freeman, W. R.

In: Investigative Ophthalmology and Visual Science, Vol. 37, No. 3, 15.02.1996.

Research output: Contribution to journalArticle

Rahhal, F. M. ; Taskintuna, I. ; Arevalo, J Fernando ; Banker, A. ; Clarke, T. ; Freeman, W. R. / Intraocular drug delivery into silicone oil-filled eyes : Experience with cidofovir (HPMPC). In: Investigative Ophthalmology and Visual Science. 1996 ; Vol. 37, No. 3.
@article{66a8331cfab44387a04d23eb5f88dfda,
title = "Intraocular drug delivery into silicone oil-filled eyes: Experience with cidofovir (HPMPC)",
abstract = "Purpose. The management of vitreoretinal diseases, such as CMV retinitis, with local pharmacologic therapy is complicated in the setting of silicone oil vitreous substitute. We have previously shown that intravitreal cidofovir is effective in the treatment of CMV retinitis and undertook this pilot study to evaluate the feasibility and efficacy of these injections in eyes filled with silicone oil. Methods. We performed 12 intraocular injections of 10ug of cidofovir in seven oil-filled eyes of six patients with CMV retinitis. The 10ug dose (half the dose previously used) was chosen because of the small volume of ocular fluid in silicone filled eyes. Injections were performed through the pars plana into the middle of the silicone oil bubble. The spherical aqueous bubble could immediately be visualized within the oil using indirect ophthalmoscopy. Eyes were examined every two weeks. None of the patients were on any other type of systemic anti-CMV therapy during the entire study period. Results. Of the eight injections (in four eyes) which had adequate follow-up, seven (87.5{\%}) resulted hi healing of the retinitis. Median time to progression after a single injection in eyes with active retinitis was 56 days. There were no cases of iritis, hypotony, or retinal redetachment with the 10ug dose. One eye had the aqueous bubble of cidofovir still undissolved in the silicone oil at the initial follow-up visit, at which time the retinitis remained active. The bubble was mechanically moved into the aqueous phase with a 27g needle and the retinitis then went on to heal without additional treatment. Conclusions. Intraocular injections directly into a silicone oil bubble can be easily and safely performed. Treatment of CMV retinitis by injecting lower-dose cidofovir with this technique appears to be safe and effective. These findings may have implications for the treatment of other vitreoretinal diseases in the presence of non-aqueous tamponading agents, including proliferative vitreoretinopathy.",
author = "Rahhal, {F. M.} and I. Taskintuna and Arevalo, {J Fernando} and A. Banker and T. Clarke and Freeman, {W. R.}",
year = "1996",
month = "2",
day = "15",
language = "English (US)",
volume = "37",
journal = "Investigative Ophthalmology and Visual Science",
issn = "0146-0404",
publisher = "Association for Research in Vision and Ophthalmology Inc.",
number = "3",

}

TY - JOUR

T1 - Intraocular drug delivery into silicone oil-filled eyes

T2 - Experience with cidofovir (HPMPC)

AU - Rahhal, F. M.

AU - Taskintuna, I.

AU - Arevalo, J Fernando

AU - Banker, A.

AU - Clarke, T.

AU - Freeman, W. R.

PY - 1996/2/15

Y1 - 1996/2/15

N2 - Purpose. The management of vitreoretinal diseases, such as CMV retinitis, with local pharmacologic therapy is complicated in the setting of silicone oil vitreous substitute. We have previously shown that intravitreal cidofovir is effective in the treatment of CMV retinitis and undertook this pilot study to evaluate the feasibility and efficacy of these injections in eyes filled with silicone oil. Methods. We performed 12 intraocular injections of 10ug of cidofovir in seven oil-filled eyes of six patients with CMV retinitis. The 10ug dose (half the dose previously used) was chosen because of the small volume of ocular fluid in silicone filled eyes. Injections were performed through the pars plana into the middle of the silicone oil bubble. The spherical aqueous bubble could immediately be visualized within the oil using indirect ophthalmoscopy. Eyes were examined every two weeks. None of the patients were on any other type of systemic anti-CMV therapy during the entire study period. Results. Of the eight injections (in four eyes) which had adequate follow-up, seven (87.5%) resulted hi healing of the retinitis. Median time to progression after a single injection in eyes with active retinitis was 56 days. There were no cases of iritis, hypotony, or retinal redetachment with the 10ug dose. One eye had the aqueous bubble of cidofovir still undissolved in the silicone oil at the initial follow-up visit, at which time the retinitis remained active. The bubble was mechanically moved into the aqueous phase with a 27g needle and the retinitis then went on to heal without additional treatment. Conclusions. Intraocular injections directly into a silicone oil bubble can be easily and safely performed. Treatment of CMV retinitis by injecting lower-dose cidofovir with this technique appears to be safe and effective. These findings may have implications for the treatment of other vitreoretinal diseases in the presence of non-aqueous tamponading agents, including proliferative vitreoretinopathy.

AB - Purpose. The management of vitreoretinal diseases, such as CMV retinitis, with local pharmacologic therapy is complicated in the setting of silicone oil vitreous substitute. We have previously shown that intravitreal cidofovir is effective in the treatment of CMV retinitis and undertook this pilot study to evaluate the feasibility and efficacy of these injections in eyes filled with silicone oil. Methods. We performed 12 intraocular injections of 10ug of cidofovir in seven oil-filled eyes of six patients with CMV retinitis. The 10ug dose (half the dose previously used) was chosen because of the small volume of ocular fluid in silicone filled eyes. Injections were performed through the pars plana into the middle of the silicone oil bubble. The spherical aqueous bubble could immediately be visualized within the oil using indirect ophthalmoscopy. Eyes were examined every two weeks. None of the patients were on any other type of systemic anti-CMV therapy during the entire study period. Results. Of the eight injections (in four eyes) which had adequate follow-up, seven (87.5%) resulted hi healing of the retinitis. Median time to progression after a single injection in eyes with active retinitis was 56 days. There were no cases of iritis, hypotony, or retinal redetachment with the 10ug dose. One eye had the aqueous bubble of cidofovir still undissolved in the silicone oil at the initial follow-up visit, at which time the retinitis remained active. The bubble was mechanically moved into the aqueous phase with a 27g needle and the retinitis then went on to heal without additional treatment. Conclusions. Intraocular injections directly into a silicone oil bubble can be easily and safely performed. Treatment of CMV retinitis by injecting lower-dose cidofovir with this technique appears to be safe and effective. These findings may have implications for the treatment of other vitreoretinal diseases in the presence of non-aqueous tamponading agents, including proliferative vitreoretinopathy.

UR - http://www.scopus.com/inward/record.url?scp=33750147225&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750147225&partnerID=8YFLogxK

M3 - Article

VL - 37

JO - Investigative Ophthalmology and Visual Science

JF - Investigative Ophthalmology and Visual Science

SN - 0146-0404

IS - 3

ER -