Dark Adaptation Abnormalities and Recovery in Acute Thioridazine Toxicity

Scholz, Richard; Sunness, Janet S.

doi:10.1097/icb.0000000000000000

Cited by 4 publications

(5 citation statements)

References 9 publications

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“…However, ERG and EOG results are markedly abnormal in later stages 171. If the drug is discontinued in the initial phases, ERG testing will improve the first year 172,173. Based off histologic studies, disorganization and atrophy of the photoreceptor outer segments occurs first, followed by secondary disruption and loss of RPE and choriocapillaris 170…”

Section: Retinal/rpe Relatedmentioning

confidence: 99%

The Impact of Systemic Medications on Retinal Function

Somisetty

Santina

Sarraf

et al. 2023

Asia-Pacific Journal of Ophthalmology

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This study will provide a thorough review of systemic (and select intravitreal) medications, along with illicit drugs that are capable of causing various patterns of retinal toxicity. The diagnosis is established by taking a thorough medication and drug history, and then by pattern recognition of the clinical retinal changes and multimodal imaging features. Examples of all of these types of toxicity will be thoroughly reviewed, including agents that cause retinal pigment epithelial disruption (hydroxychloroquine, thioridazine, pentosan polysulfate sodium, dideoxyinosine), retinal vascular occlusion (quinine, oral contraceptives), cystoid macular edema/retinal edema (nicotinic acid, sulfa-containing medications, taxels, glitazones), crystalline deposition (tamoxifen, canthaxanthin, methoxyflurane), uveitis, miscellaneous, and subjective visual symptoms (digoxin, sildenafil). The impact of newer chemotherapeutics and immunotherapeutics (tyrosine kinase inhibitor, mitogen-activated protein kinase kinase, checkpoint, anaplastic lymphoma kinase, extracellular signal-regulated kinase inhibitors, and others), will also be thoroughly reviewed. The mechanism of action will be explored in detail when known. When applicable, preventive measures will be discussed, and treatment will be reviewed. Illicit drugs (cannabinoids, cocaine, heroin, methamphetamine, alkyl nitrite), will also be reviewed in terms of the potential impact on retinal function.

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Section: Retinal/rpe Relatedmentioning

confidence: 99%

The Impact of Systemic Medications on Retinal Function

Somisetty

Santina

Sarraf

et al. 2023

Asia-Pacific Journal of Ophthalmology

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“…Paracetamol, antiemetics, mannitol if indicated 2. Peripheral laser iridotomy or lens extraction [22,23] Флуфеназин Fluphenazine Макулопатия Maculopathy [37,38] Отмена препарата Drug withdrawal [37,38] Тиоридазин Thioridazine Пигментная ретинопатия Pigmentary retinopathy [19,33,34] Отмена препарата Drug withdrawal [19,34] Атипичные нейролептики Atypical antipsychotics…”

Section: хлорпромазин Chlorpromazineunclassified

“…Тиоридазин приводит к развитию пигментной ретинопатии. По данным ограниченного числа клинических исследований, частота выявления данного побочного эффекта составляет 3 % (5/164) [34]. Токсическими считаются дозы > 800 мг/сут в течение длительного времени, однако в некоторых случаях признаки ретинопатии проявляются даже при приеме < 100 мг/сут.…”

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“…На поздних стадиях, при длительном приеме тиоридазина, наблюдается распространенная географическая или нуммулярная атрофия пигментного эпителия и хориокапилляров [33,35]. Симптомы могут возникнуть еще до появления характерных изменений на глазном дне [34]. Другое производное фенотиазина -хлорпромазин -редко приводит к пигментной ретинопатии со сходными клиническими проявлениями [33].…”

unclassified

“…Лечение заключается в прекращении приема препарата. После отмены тиоридазина острота зрения увеличивается и в некоторых случаях даже возвращается в норму, но пигментные изменения на глазном дне остаются [6,19,34]. При приеме производных фенотиазина необходимо наблюдение офтальмолога для своевременного обнаружения патологических изменений и коррекции нейролептической терапии [6,36].…”

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Adverse ocular effects of neuroleptic therapy: semiotics, pathogenesis and treatment

Panov

Petukhova

Malygin

et al. 2022

Rossijskij oftalʹmologičeskij žurnal

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Antipsychotics are widely used in psychiatric practice for treating schizophrenia, bipolar disorder, and other diseases, including those treated off-label. They manifest many adverse effects, including ophthalmic ones. Some of these effects, such as persistent mydriasis, cycloplegia, extraocular muscle dystonia, and visual hypersensitivity attacks are reversible, since they disappear after dose reduction or drug withdrawal. Yet other side effects, such as cataracts, corneal edema, acute angle closure glaucoma and retinopathy are threatening for sight and may lead to permanent visual acuity decline and even blindness. The review provides data on the incidence of ocular side effects (both typical and atypical) of multiple antipsychotics, their clinical manifestations, pathogenesis and treatment. Eye examination is recommended for patients taking antipsychotics in the early periods of treatment and then twice a year. The psychiatrists need to know about the adverse effects of individual drugs whilst the ophthalmologists should be aware of their semiotics, pathogenesis and treatment, since timely diagnosis and treatment of pathological changes, together with antipsychotic therapy modification, prevent the development of severe and irreversible visual impairment in the majority of cases.

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Thioridazine

2014

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Dark Adaptation Abnormalities and Recovery in Acute Thioridazine Toxicity

Abstract: Our findings give support to the thesis that functional visual disturbance is primarily metabolic and reversible if detected early in the course of toxicity.

Cited by 4 publications

References 9 publications

The Impact of Systemic Medications on Retinal Function

The Impact of Systemic Medications on Retinal Function

Adverse ocular effects of neuroleptic therapy: semiotics, pathogenesis and treatment

Thioridazine

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