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DRUG - RELATED RETINOPATHIES

DRUG - RELATED RETINOPATHIES. 1. Antimalarials. Chloroquine. Hydroxychloroquine. 2. Phenothiazines. Chlopromazine. Thioridazine. 3. Crystalline maculopathies. Tamoxifen. Canthaxanthin. Antimalarials. Hydroxychloroquine - very small risk of toxicity.

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DRUG - RELATED RETINOPATHIES

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  1. DRUG - RELATED RETINOPATHIES 1. Antimalarials • Chloroquine • Hydroxychloroquine 2. Phenothiazines • Chlopromazine • Thioridazine 3. Crystalline maculopathies • Tamoxifen • Canthaxanthin

  2. Antimalarials Hydroxychloroquine- very small risk of toxicity Chloroquine - risk of toxicity with cumulative dose of 300 g Advanced bull’s eye maculopathy Early bull’s eye maculopathy End-stage VA - 6/36 to 6/60 VA - 6/18 to 6/24 VA - CF

  3. FA of bull’s eye maculopathy Increased background choroidal fluorescence due to RPE window defect

  4. Phenothiazines Chlorpromazine - very small risk of toxicity Thioridazine - risk of toxicity if daily dose exceeds 800 mg • Coarse, plaque-like pigmentation • Diffuse loss of RPE and • choriocapillaris • Focal loss of RPE and • choriocapillaris

  5. Crystalline maculopathies Tamoxifen Canthaxanthin • Crystalline, ring-like macular deposits • Glistening dots arranged in • doughnut shape at posterior poles • Only with very high doses • If used over prolonged periods of time • May cause visual impairment • Visually innocuous

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