Ocular Reactions to Antimalarial Drugs

Mepacrine pigmentation in systemic lupus erythematosus.

“…In a review of twenty-five patients, Tuffanelli et al (1963) found a high incidence of ocular damage and suggested that the skin changes were markers of retinal and corneal damage. Most of their patients however had taken chloroquine-a recognized cause of ocular damage (Hobbs & Calnan, 1958Rebello, 1961;Smith, 1962). Mepacrine has been rarely associated with ocular damage but this has been largely corneal oedema (Reese, 1946) and transient scotomata (Dame, 1946) and there arc no signs of ocular damage in our patient.…”

Management of patients undergoing hydroxychloroquine (Plaquenil) therapy

“…Corneal verticillata or 'vortex keratopathy' in which greyish or golden corneal epithelial deposits appear in a vortex pattern is the other common side-effect of quinoline therapy. These deposits begin as individual white deposits but later become pigmented a n d yellowish.5 24 Later, there are yellowish curved lines in the typical vortex att tern. ".^ These deposits are not the drug itself but rather lipid inclusions which are also seen with amiodorone a n d chlorpromazine use and in the lysosomal storage diseases, such as Fabry's disease.2526 They all have a common pathophysiology in that they cause binding of anionic phospholipids of lysosymal membranes and promote intracellular inclusion^.…”

Studies on Chloroquine Retinopathy in Rabbits

“…Amounts of pigment in pigment epithelium and choroid layers are markedly increased (hematoxylin and eosin, X400). 3. Section of optic nerve of treated pigmented rabbit shows pigment between nerve fibers and in and around walls of some of neighboring blood vessels (hematoxylin and eosin, slightly reduced from X40).…”