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Update on Retinal Drug Toxicities.

S Tammy Hsu1, Arathi Ponugoti1, Jordan D Deaner1

  • 1Duke University School of Medicine, Durham, NC USA.

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PubMed
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New and commonly used medications are increasingly linked to drug-induced retinal toxicities. Advances in imaging aid early detection, but further research is needed to prevent irreversible vision loss.

Keywords:
Drug-induced maculopathyDrug-induced retinopathyHemorrhagic occlusive retinal vasculitis, Brolucizumab, Pentosan sulfateRetinal toxicityToxic retinopathy

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Area of Science:

  • Ophthalmology
  • Pharmacology
  • Toxicology

Background:

  • Drug-induced retinal toxicities are a growing concern.
  • Several medications, once considered safe, are now associated with ocular side effects.
  • Advances in imaging technology are crucial for understanding these toxicities.

Purpose of the Study:

  • To update clinicians on the clinical presentations and diagnostic findings of drug-induced retinal toxicities.
  • To highlight newly identified drug-related retinal issues.
  • To discuss the impact of evolving diagnostic capabilities.

Main Methods:

  • Review of recent literature on drug-induced retinal toxicities.
  • Analysis of clinical presentations and diagnostic findings.
  • Inclusion of data on newly approved and commonly used medications.
  • Discussion of advances in ocular imaging techniques.

Main Results:

  • Newly FDA-approved drugs (brolucizumab, MEK inhibitors, ulixertinib, FGFR inhibitors) are linked to acute retinal toxicities.
  • Increased use of medications like pentosan sulfate sodium, antiretrovirals, and intraoperative agents has revealed associated toxic retinopathies.
  • Novel findings in hydroxychloroquine and tamoxifen maculopathies are identified through advanced imaging.
  • Earlier detection of subclinical changes is possible with improved imaging.

Conclusions:

  • Increased medication use correlates with more reported retinal toxicities.
  • Advanced imaging facilitates early detection and potential prevention of disease progression.
  • Further research is required to define irreversible vision loss thresholds.
  • Careful risk-benefit assessment is necessary before discontinuing potentially life-saving therapies.