Drug Induced Corneal Deposits And Cataract : Anterior Segment Optical Coherence Tomography Findings
Published 2024 - 42nd Congress of the ESCRS
Reference: PO283 | Type: Poster | DOI: 10.82333/k53b-4252
Authors: Ahmed Mahjoub 1 , Nadia Ben Abdesslem* 1 , Ilhem Sellem 1 , Mohamed Mahmoudi 1 , Nesrine Zaafrane 1 , Mohamed Ghorbel 1
1Department of Ophthalmology,Farhat Hached University Hospital,Sousse,Tunisia
Purpose
To describe clinical and swept source anterior segment optical coherence tomography (SS AS OCT) findings in a case of corneal and crystalline lens deposits induced by antipsychotic drugs.
Setting
Farhat Hached University Hospital of Sousse, Tunisia.
Methods
A 41-year-old Caucasian woman with history of chronic schizophrenia consulted our clinic with a 2-year history of progressive deterioration of vision in both eyes associated with glare sensitivity. She was on chlorpromazine hydrochloride 300mg per day, olanzapine 20 mg per day and lithium carbonate 500 mg per day.
Results
On ophthalmic examination, visual acuity was 20/40 in the right eye (OD) and 20/32 in the left eye (OS). Slit lamp examination revealed fine brown endothelial corneal deposits in both eyes. The anterior chamber was quiet in both eyes. Intraocular pressure was normal in both bilaterally. We noted a yellowish-brown star-like shaped deposit just below the anterior capsule of the crystalline lens obscuring the visual axis in both eyes. Fundus examination of both eyes was normal. Corneal SS AS OCT of the cornea did not individualize the corneal deposits due to their small size. Nevertheless, SS AS OCT of the crystalline lens showed a hyperreflective lesion in the anterior subcapsular area corresponding to the star-like-shaped deposit.
Conclusions
Anti-psychotic drugs such as chlorpromazine are a known to cause ocular pigmentary deposits. The deposits in the ocular tissues are thought to consist of melanin and metabolites of chlorpromazine accumulated in areas exposed to sunlight due to a phototoxic reaction. Stellate shaped anterior subcapsular opacification, as demonstrated by the SS AS OCT in our case, and corneal deposits are the most frequent manifestations resulting from the exposition of these structure to sunlight. Considering regular ocular screening for patients undergoing chronic antipsychotic treatment is advisable, as it enables the timely diagnosis of any potential ocular toxicity.