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Methotrimeprazine-induced Corneal Deposits and Cataract. Jae-Woong Koh (MD/PhD) Seong-Taeck Kim (MD) Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Republic of Korea. Dr. Koh. Dr. Kim. Chosun University College of Medicine Republic of Korea. CASE REPORT. - PowerPoint PPT Presentation
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Methotrimeprazine-induced Corneal Deposits and Cataract
Jae-Woong Koh (MD/PhD)
Seong-Taeck Kim (MD)
Department of Ophthalmology,
Chosun University College of Medicine,
Gwangju, Republic of Korea
Chosun University College of Medicine
Republic of Korea
• Dr. Koh • Dr. Kim
CASE REPORT• M / 48
• C/C : visual disturbance (Onset : 6 month ago)
• P/Hx : Medication for Schizophrenia (3 yrs)- 3 mg/day of haloperidol (thioxanthenes family)- 6 mg/day of risperidone (molindone family)
• Best Corrected Visual Acuity - Right : 20/40- Left : 20/50
CASE REPORT
Fine, discrete, and brownish deposits
on the posterior cornea
CASE REPORT
Bilateral star-shaped anterior sub-capsular lens opacities
Dense dust-like granular deposits
CASE REPORT
• Patient denied but might have taken the drugs of the phenothiazine family?- Drug Profiling Test by urine samples
CASE REPORT • Pursing the past history
- Patient had taken methotrimeprazine habitually from a different doctor for about 10 years
• Diagnosis- Drug-induced corneal deposits and cataract
• Procedure- Phacoemulsification with posterior chamber
foldable intra-ocular lens implantation in both eyes
• Outcome (After 3 years of operation)- Visual acuity improved to 20/20 in both eyes
Discussion• The uses of Phenothiazines
- in schizophrenia
- in manic phases of bipolar disorder
- in the treatment of nausea (low dose)
• The Family of Phenothiazine - Chlorpromazine- Methotrimeprazine
• Long-term medication of phenothiazine- accumulates 50 times higher blood concentration (in the ocular tissue >>> in other tissues of the body)
Chlorpromazine-induced Corneal deposits and Cataract
• Greiner and Berry
- First described (1964)
- Long-term medication of chlorpromazine
- Brown granular pigmentation in cornea
- Central star-shaped opacity in the center
of anterior capsular lens
Can Med Assoc J 1964; 90:663-665
Discussion
• Chlorpromazine-induced Corneal deposits and
Cataract
- some cases reported
• However !!!Methotrimeprazine-induced Corneal deposits and
Cataract
- Unusual and Rare case / specially confirmed by Drug Profiling Test by urine samples