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Deferoxamine-related bilateral maculopathy with optical coherence tomography findings
Neslihan Bayraktar Bilen1, Burcu Polat Gültekin2, Simten Dagdas3
1Department of Ophthalmology, Ankara Bilkent City Hospital, Üniversiteler Mahallesi 1604. Cadde No: 9, Gayret Mah. Oruc Reis Sk. Parkciftlik Konutlari CK-6/17, Yenimahalle, Çankaya, Ankara, Turkey.
Photodiagnosis and Photodynamic Therapy
|January 1, 2024
Summary
Deferoxamine (DFO) treatment can cause acute retinal toxicity, leading to vision loss. Early detection and stopping DFO therapy can restore visual function, though some retinal changes may persist.
Area of Science:
- Ophthalmology
- Hematology
- Toxicology
Background:
- A case study investigating bilateral maculopathy in a patient undergoing deferoxamine mesylate (DFO) therapy for myelodysplastic syndrome (MDS).
- The patient presented with blurred vision, prompting an ophthalmological evaluation.
Observation:
- Diagnosis of bilateral neurosensory retinal detachment of the macula.
- Ocular imaging included optical coherence tomography (OCT), fundus fluorescein angiography (FFA), and fundus autofluorescence (FAF).
Findings:
- Initial OCT revealed bilateral foveal neurosensory detachment; FFA showed macular and peripapillary hyperfluorescence.
- Following DFO discontinuation, best corrected visual acuity (BCVA) improved from 20/120 to 20/60, with OCT confirming resolution of foveal detachments.
- Subsequent FAF demonstrated bilateral mottled hyper- and hypoautofluorescence in the macula and peripapillary regions.
Implications:
- Deferoxamine mesylate is associated with acute retinal toxicity.
- Hematologists should monitor for visual disturbances in patients on DFO therapy.
- Prompt diagnosis and cessation of DFO can lead to visual recovery, despite potential residual fundus abnormalities.
