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Using Retinal Imaging to Study Dementia
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MULTIMODAL IMAGING OF DIDANOSINE-RELATED RETINOPATHY.

João Gabriel Alexander1, Gustavo Albrecht Samico, Lucas Zago Ribeiro

  • 1Department of Ophthalmology and Visual Science, Escola Paulista de Medicina (EPM), Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.

Retinal Cases & Brief Reports
|April 17, 2026
PubMed
Summary

This case report details a rare instance of didanosine-related retinopathy, identified through multimodal imaging. The findings highlight the importance of advanced imaging and genetic testing for diagnosing this vision-impacting condition.

Keywords:
antiretroviraldidanosinemultimodalretinopathytoxicity

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Area of Science:

  • Ophthalmology
  • Retinal Diseases
  • Toxicology

Background:

  • Didanosine is an antiretroviral medication used in HIV treatment.
  • Chorioretinal toxicity is a potential, though rare, side effect of didanosine.
  • Early identification of didanosine-related retinopathy is crucial for managing visual impairment.

Purpose of the Study:

  • To document the multimodal imaging characteristics of a rare case of didanosine-related retinopathy.
  • To emphasize the diagnostic utility of advanced imaging techniques in this condition.

Main Methods:

  • Case report methodology.
  • Multimodal imaging including fundus examination, autofluorescence, and optical coherence tomography.
  • Genetic testing to rule out inherited retinal dystrophies.

Main Results:

  • A 55-year-old male with HIV on long-term didanosine presented with peripheral visual loss and nyctalopia.
  • Imaging revealed bilateral, symmetrical peripheral chorioretinal atrophy, sparing the macula.
  • Genetic testing excluded hereditary retinal conditions.

Conclusions:

  • Didanosine-induced chorioretinal toxicity is an uncommon diagnosis with limited literature.
  • Multimodal imaging and genetic testing are vital for accurate diagnosis.
  • Late presentation can complicate the assessment of early toxicity signs and disease progression after medication cessation.