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2017 ; 5
(ä): 119-123
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Amiodarone: A potential risk factor for retinal phototoxicity
#MMPMID29503963
Joshi KM
; Gill MK
Am J Ophthalmol Case Rep
2017[Apr]; 5
(ä): 119-123
PMID29503963
show ga
PURPOSE: To report the only known case, to our knowledge, of amiodarone induced
retinal phototoxicity following vitrectomy surgery. OBSERVATIONS: A 66-year-old
male presented with visual acuity of 20/150 OS secondary to an epiretinal
membrane (ERM). Patient was on oral amiodarone for atrial fibrillation. Baseline
spectral domain optical coherence tomography (SD-OCT) revealed an ERM with
retinal thickening and schisis. The patient underwent an uncomplicated pars plana
vitrectomy and membrane peel using standard vitrectomy settings and illumination.
Triamcinolone was used to stain the ERM intraoperatively. ICG was not used. On
post-operative day one, vision was count finger (CF) at 1'. At post-operative
week one, vision was unchanged and SD-OCT showed macular edema. At post-operative
month one, vision remained CF at 1' and macular edema resolved with residual
pigmentary changes and subretinal fibrosis resembling phototoxic damage. SD-OCT
at one month showed resolution of macular edema, retinal pigment epithelium
hyperplasia and an indistinct ellipsoid layer. Fluorescein angiography did not
show any neovascularization. At three month follow-up, patient's vision, exam and
OCT findings remained unchanged. CONCLUSIONS AND IMPORTANCE: Many pharmacologic
agents have the ability to alter a patient's sensitivity to solar or artificial
radiation. Drugs act as photosensitizers that lead to photochemical damage.
Amiodarone has been reported to have such photosensitizing properties in humans.
This report describes a case of retinal phototoxicity from intraoperative light
exposure photosensitized by systemic amiodarone use.