Medications Damaging Retinal Pigment Epithelium and Photoreceptor Complex-3: Pathogenesis, Diagnosis and Treatment (Clofazimine, Deferoxamine, Vitamin A Deficiency and Celiac Disease, Digoxin)

Abstract

Toxic retinopathies are a variety of conditions resulting from retinal damage caused by systemically administered drugs. Although relatively rare, these conditions should be considered, especially when features of unusual retinopathy or maculopathy such as bilateral pigmentary disorder or retinal crystal deposition are present. It has been observed that some drugs damage the RPE and photoreceptor layer. Of these drugs, clofazimine; can be used in the treatment of tuberculosis, leprosy, and various cutaneous diseases, but it can cause color vision defects and bulls-eye maculopathy in a dose-dependent manner. Lesions detectable by various imaging methods have been described as associated with the use of deferoxamine mesylate, which is used as an iron-chelating agent. In vitamin A deficiency characterized by xerophthalmia symptoms, drusenoid deposits have been observed in the photoreceptor outer segment, in which rod function defects are prominent. In the use of digoxin, which has a very narrow therapeutic range, photoreceptor dysfunctions, which are manifested by deterioration in color perception, may develop. Most ocular side effects associated with systemic drug use are reversible after discontinuation of therapy if detected early. However, toxic effects can progress if undetected and cause retinal dysfunction associated with potentially irreversible vision loss.