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Ritonavir and bull's eye maculopathy: case report
Rita Pinto1, Marta Vila-Franca1, Cláudia Oliveira Afonso2
1Instituto de Oftalmologia Dr Gama Pinto, Lisboa, Portugal.
Objective:
To report on a case of retinal pigment epithelium (RPE) toxicity apparently associated with ritonavir.
Methods:
We describe a case of gradual-onset blurry vision in both eyes in a 30-year-old HIV-positive male on Highly-Active Antiretroviral Therapy (HAART) including ritonavir Results: The patient presented with a visual acuity of 3/10 in each eye, and fundoscopy revealed paracentral pigment mottling. Computerized perimetry showed a ring-scotoma in both eyes. Fluorescein angiography revealed an anular RPE defect in both eyes, congruent with hyperautofluorescent changes on autofluorescence imaging. Full-field ERG was normal.
Conclusions:
Since ritonavir has previously been linked with toxicity to the RPE, we consider this report as further evidence of this association.
