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Drug-induced retinal disorders

FEATURED REVIEW Retinal damage can cause different types of visual disturbances, of varying severity. Many drugs can provoke retinal disorders. What are the underlying mechanisms? Which drugs are responsible?
Full review (4 pages) available for download by subscribers.

Abstract

  • Some of the products implicated in retinal disorders are for ocular use, and cause retinal disorders due to the substances they contain or their method of administration (e.g. intravitreal injection). Other drugs impair retinal function when taken systemically.
     
  • When a drug is identified as the cause of a retinal disorder, its harm-benefit balance should be reviewed. Discontinuing the offending drug or reducing the dose usually restores the patient’s vision, at least partially.
     
Drug-induced retinal disorders: an overview of pharmacovigilance reports in France

A study, based on the 123 687 adverse effects recorded in the French pharmacovigilance database between 2008 and 2012, identified 164 retinal disorders, including: retinal vascular disorders (40%), macular oedema (19%), damage to the retinal pigment epithelium (10%), retinal detachment (10%) and chorioretinopathy (simultaneous damage to both the retina and the choroid) (5%). The patients were aged 14 to 84 years (median: 59 years). These retinal disorders were considered serious in 82% of cases. Sequelae were reported in 24% of cases: persistent decrease in visual acuity, visual field defects, and vision loss. The main drugs for which a statistically significant association with retinal disorders was found were: antirheumatics (hydroxychloroquine, chloroquine), anti-infectives (interferon alfa), antineoplastics (imatinib and letrozole), raloxifene, epoetin beta, and ranibizumab.

Source: Bourgeois N et al. "Atteintes rétiniennes iatrogènes: étude cas/non cas dans la banque nationale de pharmacovigilance" Thérapie 2016; (71): 365-374.


Full review (4 pages) available for download by subscribers.

©Prescrire 1 May 2019

"Drug-induced retinal disorders" Prescrire Int 2019; 28 (204): 124-127. (Pdf, subscribers only).

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Download the full review.
Pdf, subscribers only