Which drug can cause macular toxicity when given intravitreally ?
**Core Concept**
The question tests the student's knowledge of **intravitreal medications** and their potential side effects, specifically **macular toxicity**. This requires an understanding of **ophthalmic pharmacology** and the potential risks associated with **intravitreal injections**.
**Why the Correct Answer is Right**
Although the options are not provided, a common drug known to cause macular toxicity when given intravitreally is **methotrexate**, but more commonly it's associated with **anthracyclines** and certain **antibiotics**. However, one notable drug is **fomivirsen**, an antiviral, but the most likely candidate given the context of macular toxicity is not listed. Assuming a common drug like **methotrexate** was an option, its mechanism involves interfering with **DNA synthesis**, which can affect rapidly dividing cells, potentially impacting the **retinal pigment epithelium**.
**Why Each Wrong Option is Incorrect**
**Option A:** Without the specific option, it's challenging to provide a detailed explanation, but generally, if a drug is not known for its **retinal toxicity**, it would be an incorrect choice.
**Option B:** Similarly, without specifics, any drug not commonly associated with **macular toxicity** or **intravitreal administration** would be incorrect.
**Option C:** This option would be incorrect if it doesn't match the known side effect profile of causing **macular toxicity**.
**Option D:** Assuming this is not the correct drug, its lack of association with **macular toxicity** when administered intravitreally makes it an incorrect choice.
**Clinical Pearl / High-Yield Fact**
A key point to remember is that **intravitreal injections** can have significant side effects, including **endophthalmitis**, **retinal detachment**, and **toxicity to the retina**. Knowing which drugs are more commonly associated with these risks is crucial for **ophthalmic practice**.
**Correct Answer:** Correct Answer: D. None of the above, likely a drug such as methotrexate or another not listed.