ABSTRACT
Two cases of retinopathy possibly caused by the antiepileptic drug, carbamazepine (Tegretol) are presented. Two female patients in middle age with epilepsy had been treated with carbamazepine for more than 7 years when they experienced sudden visual disturbances and reduction of visual acuity without known concomitant systemic toxic effects. Ophthalmoscopy, fundus colour photography and fundus fluorescein angiography disclosed in one patient discrete, and in the other patient extensive lesions of the retinal pigment epithelium in the posterior poles of the eyes including the macular regions. Discontinuation of carbamazepine led to improvement of visual function and of the morphological changes in the fundi of the patient with the most pronounced lesions. It is suggested that carbamazepine, a drug nearly chemically identical with the tricyclic psychotropic agents, might cause damage of the retinal pigment epithelium in long-term treatment. Further clinical controlled studies of the possible retinotoxic effect of this agent are, however, required.
Subject(s)
Carbamazepine/adverse effects , Retinal Detachment/chemically induced , Vision Disorders/chemically induced , Adult , Evoked Potentials, Visual/drug effects , Female , Fluorescein Angiography , Humans , Vision Disorders/diagnosis , Visual Acuity/drug effectsABSTRACT
A 63-years-old male with pernicious anemia had been treated for 20 years with weekly injections of iron-dextran and cyanocobalamine. Ophthalmological examination revealed the ophthalmoscopic picture of a tapetoretinal degeneration, reduced visual acuity and narrow visual fields. ERG and dark-adaptation test were normal. Hematological examination including liver and bone marrow biopsies gave no support for the existence of systemic siderosis. It is proposed that the retinal degeneration is due to the extensive parenteral iron treatment with a total dose of approximately 100 grams of iron. This theory is supported by a previous experimental report.
