Clinical observations of ocular quinine intoxication

A case of a 13-year-old boy with ocular quinine intoxication was reported. He had been diagnosed as having cerebral malaria and had received quinine dihydrochloride for one week by intravenous drip infusion; the total dose was 12.6 g. When the patient was examined by us at the time of admission to our Hospital the visual acuity was zero in both eyes. During the hospitalization, recordings of electroretinogram and visually evoked potential were repeated, in addition to the conventional ophthalmological examinations. Although no particular treatment was given, the visual acuity showed a gradual recovery in both eyes; it was 20/200 at the 4th week and 20/30 at the 21st week after admission. Fluorescein fundus angiography at one week after admission revealed a moderate narrowing of the retinal arterioles and a slight reduction of capillaries on the optic disk. The electroretinogram and visually evoked potential were nonrecordable initially, but they showed recovery concomitantly with the recovery of the visual acuity. It was suggested that all of the retinal layers and also the optic nerve were affected by the intoxication.