A woman with didanosine retinopathy and non-cirrhotic portal hypertension

Pinto, Rui; Lino, Sara; Nogueira, Virginia Paiva Figueiredo; Fonseca, Ana Catarina; Ornelas, C

doi:10.1177/0956462412472817

Cited by 8 publications

(14 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, this drug also inhibits the synthesis of mitochondrial DNA (mtDNA), resulting in mitochondrial toxicity and in rare cases precipitating a retinopathy similar to those seen in other mitochondrial disorders [185]. In the six cases described in the literature, adult DDI toxicity presents as sharply demarcated, midperipheral, concentric chorioretinal atrophy [186–189]. Widefield FAF is essential in making the diagnosis and shows a characteristic mottled hyper-autofluorescence and hypo-autofluorescence in the midperiphery that spares the central macula (Fig.…”

Section: Drug Toxicitymentioning

confidence: 99%

Clinical applications of fundus autofluorescence in retinal disease

2016

View full text Add to dashboard Cite

Fundus autofluorescence (FAF) is a non-invasive retinal imaging modality used in clinical practice to provide a density map of lipofuscin, the predominant ocular fluorophore, in the retinal pigment epithelium. Multiple commercially available imaging systems, including the fundus camera, the confocal scanning laser ophthalmoscope, and the ultra-widefield imaging device, are available to the clinician. Each offers unique advantages for evaluating various retinal diseases. The clinical applications of FAF continue to expand. It is now an essential tool for evaluating age related macular degeneration, macular dystrophies, retinitis pigmentosa, white dot syndromes, retinal drug toxicities, and various other retinal disorders. FAF may detect abnormalities beyond those detected on funduscopic exam, fluorescein angiography, or optical coherence tomography, and can be used to elucidate disease pathogenesis, form genotype-phenotype correlations, diagnose and monitor disease, and evaluate novel therapies. Given its ease of use, non-invasive nature, and value in characterizing retinal disease, FAF enjoys increasing clinical relevance. This review summarizes common ocular fluorophores, imaging modalities, and FAF findings for a wide spectrum of retinal disorders.

show abstract

Section: Drug Toxicitymentioning

confidence: 99%

Clinical applications of fundus autofluorescence in retinal disease

2016

View full text Add to dashboard Cite

show abstract

“…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%

“…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%

“…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%

See 2 more Smart Citations

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.

View full text Add to dashboard Cite

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.

show abstract

Didanosine

2014

Reactions Weekly

View full text Add to dashboard Cite

A woman with didanosine retinopathy and non-cirrhotic portal hypertension

Abstract: We present a case of structural and functional changes compatible with didanosine retinopathy in a patient who also developed non-cirrhotic portal hypertension.

Cited by 8 publications

References 14 publications

Clinical applications of fundus autofluorescence in retinal disease

Clinical applications of fundus autofluorescence in retinal disease

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

Didanosine

Contact Info

Product

Resources

About