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Clinical observations of ocular quinine intoxication
Japanese Journal of Ophthalmology
|January 1, 1984
Summary
A 13-year-old boy experienced complete vision loss due to quinine intoxication from cerebral malaria treatment. His vision gradually recovered over weeks, suggesting retinal and optic nerve involvement.
Area of Science:
- Ophthalmology
- Toxicology
- Pharmacology
Background:
- Quinine is a crucial antimalarial drug, but its use can lead to toxicity.
- Ocular toxicity is a known, albeit rare, side effect of quinine treatment.
Observation:
- A 13-year-old boy treated for cerebral malaria with 12.6g of quinine dihydrochloride presented with complete vision loss.
- Ophthalmological examinations, including electroretinogram (ERG) and visually evoked potential (VEP), were performed.
- Fluorescein fundus angiography showed retinal arteriolar narrowing and reduced optic disc capillaries.
Findings:
- Initial ERG and VEP were nonrecordable, correlating with zero visual acuity.
- Visual acuity gradually improved, reaching 20/200 by week 4 and 20/30 by week 21 without specific ocular treatment.
- ERG and VEP showed recovery concurrent with visual acuity improvement.
Implications:
- This case highlights the potential for severe ocular toxicity from quinine, affecting retinal layers and the optic nerve.
- The findings suggest that quinine intoxication can cause reversible visual impairment.
- Monitoring visual function is important in patients receiving high-dose quinine therapy.