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Methoxsalen-induced advanced bull's eye maculopathy
Ratnesh Ranjan1, George J Manayath1, Romit Salian1
1Department of Vitreo-Retina Services, Aravind Eye Hospitals & Postgraduate Institute of Ophthalmology, Coimbatore, India.
European Journal of Ophthalmology
|February 18, 2020
Summary
Methoxsalen-ultraviolet A therapy can cause advanced bull's eye maculopathy, a severe form of macular degeneration. This case highlights the potential ocular toxicity of this treatment, emphasizing the need for careful monitoring.
Area of Science:
- Ophthalmology
- Dermatology
- Toxicology
Background:
- Systemic medications can induce macular toxicity, with bull's eye maculopathy linked to drugs like hydroxychloroquine.
- Methoxsalen-ultraviolet A (MUA) therapy is a treatment for conditions like vitiligo.
Observation:
- A 55-year-old female with vitiligo, previously treated with MUA therapy, presented with painless vision loss.
- Fundus examination revealed bull's eye maculopathy, and optical coherence tomography showed photoreceptor damage and outer retinal thinning.
- Multifocal electroretinogram indicated widespread macular dysfunction.
Findings:
- The patient was diagnosed with advanced methoxsalen-induced macular toxicity.
- This represents the first reported instance of MUA therapy causing advanced bull's eye maculopathy.
Implications:
- This case underscores the potential for MUA therapy to cause significant ocular toxicity.
- Ophthalmologists and dermatologists should be aware of this risk and consider visual function monitoring in patients undergoing MUA therapy.
