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Related Experiment Videos

Quinine amblyopia: is current management appropriate?

E H Dyson, A T Proudfoot, D N Bateman

    Journal of Toxicology. Clinical Toxicology
    |January 1, 1985
    PubMed
    Summary
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    Quinine overdose can cause blindness. Treatments like stellate ganglion block did not restore vision in patients with quinine-induced oculotoxicity, suggesting these interventions lack a rational basis.

    Area of Science:

    • Ophthalmology
    • Toxicology
    • Neurology

    Background:

    • Quinine overdose is a known cause of visual impairment and blindness.
    • The toxic effects of quinine primarily target retinal photoreceptor cells.
    • Previous treatments aimed at increasing retinal blood flow have been used for quinine-induced visual loss.

    Purpose of the Study:

    • To evaluate the efficacy of various treatments, including stellate ganglion block, for visual recovery in patients with quinine-induced blindness.
    • To determine if interventions targeting retinal blood flow are beneficial in cases of quinine oculotoxicity.

    Main Methods:

    • Retrospective case series of thirty-one patients with blindness due to quinine overdose.
    • Patients received different treatments: bilateral stellate ganglion block, unilateral stellate ganglion block, other vasodilatory treatments, or no specific treatment.

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  • Visual outcomes were assessed at follow-up.

    • Main Results:

    • Nine out of thirty-one patients recovered complete vision; twenty had persistent visual field constriction, and one remained blind.
    • No significant visual improvement was observed in patients receiving stellate ganglion block or other vasodilatory treatments.
    • One patient died from cardiotoxicity secondary to quinine overdose.

    Conclusions:

    • Treatments aimed at increasing retinal blood flow, such as stellate ganglion block, are not effective for quinine-induced oculotoxicity.
    • The primary mechanism of quinine toxicity on photoreceptor cells renders vasodilator therapies irrational.
    • Current treatment strategies for quinine-induced visual loss should be re-evaluated based on the understanding of its toxic effects.