Multimodal imaging in deferasirox-mediated retinopathy.

Area of Science:

• Ophthalmology
• Pharmacology
• Medical Imaging

Background:

• Deferasirox is an oral iron chelator used for managing iron overload.
• Pigmentary retinopathy is a rare but serious adverse effect of deferasirox.
• This study presents the first multimodal imaging case of deferasirox retinopathy in an adult.

Observation:

• A 63-year-old male with end-stage renal disease and transfusion-dependent anemia developed asymptomatic pigmentary changes.
• The patient had been on deferasirox for one year.
• Clinical presentation was asymptomatic pigment epitheliopathy.

Findings:

• Optical coherence tomography showed outer retinal and retinal pigment epithelial discontinuity.
• Fundus autofluorescence demonstrated hypoautofluorescence in affected areas.
• Fluorescein angiography revealed blocking patterns consistent with pigmentary changes.
• Multifocal electroretinography indicated subtle reductions in retinal function.

Implications:

• Regular retinal examinations are recommended for patients on chronic deferasirox therapy.
• Multimodal imaging is crucial for diagnosing and characterizing deferasirox-induced retinopathy.
• Early detection of visual disturbances may prevent further vision loss.