Progressive chorioretinopathy after receiving thioridazine.

Area of Science:

• Ophthalmology
• Pharmacology
• Toxicology

Background:

• Thioridazine hydrochloride (Mellaril) is an antipsychotic medication.
• High doses have been anecdotally linked to ocular complications.

Observation:

• A distinct ocular fundus appearance was noted as a late complication.
• Discrete, nummular areas of retinal pigment epithelium (RPE) loss were observed from the posterior pole to the midperiphery.

Findings:

• Fluorescein angiography revealed choriocapillaris loss in affected RPE zones.
• RPE atrophy was progressive, advancing even after thioridazine discontinuation.
• Late-stage abnormalities included impaired dark adaptation, electroretinogram, and electro-oculogram results.

Implications:

• This study details a specific pattern of RPE atrophy caused by thioridazine hydrochloride.
• The progressive nature of the atrophy highlights potential long-term visual impairment risks.
• Ophthalmologists should be aware of these potential ocular side effects associated with thioridazine use.