Common toxic retinopathies:
Antimalarials – chloroquine / hydroxycholoroquine
Maculopathy – once ‘bull’s eye retinopathy’ develops, it is irreversible.
Management: Refer to RCOphth guidelines 2020.
Quinine toxicity –> retinal oedema, fixed dilated pupils, attenuated arterioles, constricted visual fields & optic nerve atrophy.
Medication for schizophrenia.
Thioridazine (normal dose: 150-600mg/day) – >800mg/day few wks –> toxicity.
Chlorpromazine (Largactil) (normal dose: 75-300mg/day) – >2400mg/day few wks –> toxicity
Beginning – pigmentary changes – “salt and pepper” appearance –> geographic atrophy (late stages)
Anti oestrogen treatment for breast carcinoma.
Usual dose is 20-40mg/day.
Vortex keratopathy and optic neuritis – rare and reversible.
Extent corresponds with amount and duration of drug abuse (cocaine or methylphenidate/Ritalin).
Multiple tiny yellow-white glistening particles over posterior pole.
Can lead to macular oedema, flame-shaped haemorrhages and arterial occlusion with talc emboli.
Microtalc retinopathy – NFL defect like glaucoma.
Refer to respiratory physician as ocular talc indicates lung function may be compromised.