Retinopatia associada ao uso de didanosina

Muralha, Acácio; Reisner, Márcio L.; Curi, André Luis Land

doi:10.1590/s0004-27492001000500017

Cited by 4 publications

(8 citation statements)

References 8 publications

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“…Bull’s eye maculopathy occurring outside the setting of 4-aminoquinoline use, although reported, is unusual [ 2 ]. Three drugs used in the treatment of AIDS-related disorders have previously been linked with retinal epitheliopathy: the protease inhibitor ritonavir [ 3 ] (Norvir ® ); clofazimine (Lamprene ® , Ciba Pharmaceuticals, Summit, NJ) [ 4 ], used in the management of atypical mycobacterial infections, and the reverse transcriptase inhibitor didanosine (Videx ® , Bristol-Myers Squibb, Princeton, NJ) [ 5 ], [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Ritonavir and bull’s eye maculopathy: case report

Pinto¹,

Vila-Franca²,

et al. 2013

GMS Ophthalmology Cases; 3:Doc01; ISSN 2193-1496

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Section: Discussionmentioning

confidence: 99%

Ritonavir and bull’s eye maculopathy: case report

Pinto¹,

Vila-Franca²,

et al. 2013

GMS Ophthalmology Cases; 3:Doc01; ISSN 2193-1496

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“…In our case series, 50% reported peripheral visual field symptoms, but these cases had significant chorioretinal atrophy encroaching on the macula, and none of the patients had sought medical advice prior to referral. Similarly, only 33% of patients in previously reported cases had any visual symptoms, and most were incidental findings [4][5][6][7][8][9][10][11]. DART is largely asymptomatic, at least in the initial stages; hence, the true prevalence of the disease may therefore be underestimated.…”

Section: Visual Acuity and Symptomsmentioning

confidence: 99%

“…We reviewed all 19 reported DART cases amongst adult HIVpositive patients [5,[7][8][9]11], and herein, we discuss the features of our four cases compared to the published literature.…”

Section: Literature Reviewmentioning

confidence: 99%

“…To date since 1992, there have been numerous reported cases of didanosine-associated retinal toxicity (DART) amongst adults [4][5][6][7][8][9][10][11]. The reported clinical findings of DART range from mild mid-peripheral pigmentary stippling to extensive patches of chorioretinal atrophy which can affect the macula in advanced cases [4][5][6][7][8][9][10][11]. Patients are initially asymptomatic, but in advanced disease, they can present with significant peripheral visual field defects and nyctalopia [4][5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…The reported clinical findings of DART range from mild mid-peripheral pigmentary stippling to extensive patches of chorioretinal atrophy which can affect the macula in advanced cases [4][5][6][7][8][9][10][11]. Patients are initially asymptomatic, but in advanced disease, they can present with significant peripheral visual field defects and nyctalopia [4][5][6][7][8][9][10][11]. Despite the cessation of DDI, in some cases, the chorioretinal atrophy continues to extend posteriorly with resultant severe visual field constriction [7].…”

Section: Introductionmentioning

confidence: 99%

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Didanosine-Associated Retinal Toxicity (DART) Amongst HIV-Positive Patients: a Case Series and Literature Review

Nderitu

Riga

Mann

et al. 2020

SN Compr. Clin. Med.

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The aim of this study is to report on didanosine-associated retinal toxicity (DART) in four adult patients with human immunodeficiency virus (HIV) identified incidentally during routine diabetic eye screening and review all reported cases to date. This study is a retrospective, observational, case series from two health institutions with a review of published literature. DART is often asymptomatic, and patients have good vision (mean visual acuity 6/9), but in advanced cases, severe visual field defects can occur. Fundal changes range from mild granular pigmentary mottling to patches of mid-peripheral chorioretinal atrophy. Continuous expansion of chorioretinal degenerative changes posteriorly may lead to significant macular involvement as demonstrated in two of our cases. Despite cessation of therapy, DART was progressive in approximately 25% of reported cases. Our cases were incidentally discovered during routine diabetic eye screening and did not report any ocular symptoms prior to referral. Given the initial asymptomatic nature of DART, we believe that the true prevalence of the disease may be higher than previously thought. It may be prudent to screen and follow-up patients with a history of DDI use. We demonstrate the utility of multimodal imaging, optical coherence tomography, electrodiagnostic testing and visual fields in evaluating the effects of DART.

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