2073 – Retinopathy induced by zuclopentixol depot: A case report

Abstract

Neuroleptics constitute an heterogeneus group of drugs used to treat mental illness. As known, long-acting depot neuroleptics receive increasing consideration in the maintenance treatment of individuals diagnosed of schizophrenia with low insight or poor treatment adherence. Zuclopentixol depot is a typical antipsychotic agent. It operates through a mechanism of extended release. It is characterized by antagonizing Dopamine receptors, particulary D2. It also works on alfa1 adrenergic and serotonine 2A receptors. Its effect on histamine H1 receptors is weak, and presents no affinity with cholinergic receptors. The literature reports ocular disorders due to treatment with neuroleptics. Typical antipsychotic can induce degenerative retinopathy which histologically and clinically simillar to primary pigmentary retinitis. Nevertheless, after showing initial interest, clinicians and researches no longer paid enough attention to them. Most of the cases reported are related to Phenotiazine antipsychotic family. Phenotiazines bind to melanin granules and can cause a severe phototoxic retinpathy. We have not found retinal disorders caused by Zuclopentixol in the literature reviewed. Pathogenis involved in retinopathia induced by neuroleptics is still unknown. Neuroleptics operate through a mechanism based on the antagonism of dopaminergic receptors. This blockade may influence the genesis of retinopathy. Several hypothesis emphasized in how neuroleptics, by antagonizing dopaminergic receptors, can influence melanine absortion in the uveal track and choroid. This is the reason why there could be a relation between antidopaminergic mechanism and choroid through the vascular supply.