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NR. 4/2004
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Polekowe zmiany w
narządzie wzroku
Ocular changes induced by systemic medications
Mirosława Grałek, Krystyna
Kanigowska, Dorota Klimczak-Ślączka
Klinika Okulistyki Instytutu – Pomnika „Centrum Zdrowia Dziecka”
Kierownik: prof. dr hab. med. Mirosława Grałek |
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| Summary: |
Numerous systemic
medications produce adverse effects that involve the eye.
These groups include corticosteroids, antihyperglicemic
agents, oral contraceptives, antirheumatic drugs,
chemotherapeutic substances, antidepressant and
antypsychotic medications, antiepileptic agents, cardiac
agents, same antibiotics. This paper describes the most
common, various ocular changes associated with systemic
medications use. For each group of medications, the
ocular changes are described. The most important ocular
side effect of the systemic administration of
corticosteroids is the formation of cataract, glaucoma,
and symptoms of benign intracranial hypertension.
Hyperglicemia treatment with insulin rapidly causes
refractive changes. Thrombotic retinal vascular disease,
such as retinal vein occlusion, cataract, and dry eye
symptoms may be caused by oral contraceptives.
Antirheumatic medications (hydroxychloroquine and
chloroquine) have been associated with retinal toxicity.
Clinical implication of using these is almost always
irreversible makulopathy with central vision loss.
Keratopathy and/or lenticular deposits are also observed.
Chemotherapeutic agents caused symptoms that can imitate
functional disorder such as blurred vision, photophobia,
accomodation disturbances, ocular motility dysfunction,
and dry eye complaints. Nystagmus, diplopia, and
extraocular muscle palsy have been associated with
central nervous system depressants. Chlorpromazine and
thioridazine known to induce lens deposits and
pigmentary retinopathy. Visual disturbances are common
side effect of many antiepileptic medications.
Anticonvulsants use have been associated with concentric
visual field loss, central visual function deficits
including reduced contrast sensitivity and abnormal
colour perception. Medications used in cardiology,
especially antiarrhytmic digitalis and amiodarone, cause
ocular disturbances producing chromatopsia (yellow or
green tint), blurred vision, and corneal microdeposits
or deposits of lens during amiodarone treatment.
Ethambuthol and isoniazid have been implicated to cause
loss vision, visual field defect and color vision
disturbances. Optic neuritis may be caused by
chloramphenicol. |
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| Key words: |
systemic medications,
ocular complications. |
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