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Drug-induced corneal complications.
David A Hollander1, Anthony J Aldave
1The Cornea Service, Jules Stein Eye Institute, The University of California, Los Angeles, California 90095, USA.
Current Opinion in Ophthalmology
|November 4, 2004
Summary
Systemic medications can cause various corneal changes, including lipidosis and microcysts, affecting vision. Monitoring patients for ocular toxicity is crucial, though changes often resolve after discontinuing the drug.
Area of Science:
- Ophthalmology
- Pharmacology
- Corneal Medicine
Background:
- Systemic medications can manifest in the cornea through tear film, aqueous humor, or limbal vasculature.
- Corneal changes are frequently linked to the inherent chemical properties of the drugs administered.
Purpose of the Study:
- To review common corneal manifestations of systemic medications.
- To describe characteristic clinical features, indications for drug cessation, and risks of irreversible ocular toxicity.
Main Methods:
- Literature review of systemic medications and their corneal effects.
- Analysis of drug properties and their correlation with specific corneal changes.
- Evaluation of clinical presentations and patient outcomes.
Main Results:
- Amphiphilic medications (e.g., amiodarone) can cause lipidosis and vortex keratopathy.
- Antimetabolites (e.g., cytarabine) may lead to epithelial microcysts.
- Corneal deposition, visual disturbances, photophobia, and irritation are common, often dose-related and reversible upon drug cessation.
Conclusions:
- Systemic drugs can impact all corneal layers, with deposition being a key feature.
- Corneal deposition itself is usually not a reason to stop medication.
- Close monitoring for symptoms and irreversible ocular toxicity is essential for patients on specific systemic drugs.