[Bull's-Eye Maculopathy with Deferoxamine Treatment]

A bull's-eye maculopathy can be provoked by drugs.

A 67-year-old man observed transient green-yellow spots with both eyes. The visual acuity was 1.0 in the right eye and 0.9 in the left. Tiny pigmentary irregularities of the macula were observed by ophthalmoscopy. Fluorescein angiography revealed a cockade formation of the macula. The multifocal ERG showed normal latencies in the periphery, however, in the centre the amplitudes were reduced to approximately half of the normal values. An acute myeloid leukaemia was diagnosed in 1997 which arose from a myelodysplasia, after performance of a peripheral allogenic blood stem cell transplantation. Because of a serious anaemia, the patient received numerous multiple transfusions with packed blood red cells from April 1999 to April 2000 (a total of more than 90 transfusions). In consequence, a haemosiderosis occurred with a ferritin value of 4390 ng/ml (November 1999) which made treatment with deferoxamine necessary. Multiple injections of deferoxamine (one to two grams were given from August 2000 until February 2001, afterwards an intermittent application until November 2002 was carried out) which resulted in the maculopathy.

Retinal changes, in particular, a maculopathy, should be considered even if visual acuity and visual fields are not remarkably changed. Dependent on the extent of the disease, deferoxamine treatment should be discontinued in case of distinct visual deterioration.