A 51-YEAR-OLD white woman with a long history of psychiatric problems
and no family history of hereditary retinal degeneration experienced decreased
vision in both eyes for several years. She had received thioridazine hydrochloride
(Mellaril; Sandoz Pharmaceutical Co, Hanover, NJ) 300 mg daily from 1978 through
1997 and chlorpromazine hydrochloride (Thorazine; SmithKline Beecham, Philadelphia,
Pa) 600 mg daily from 1986 through 1998.
Best-corrected visual acuity was 20/60 OD and 20/100 OS with markedly
constricted visual fields and central scotomas in both eyes. Anterior segment
and vitreous were normal, but both eyes had large patches of atrophy outside
the arcades and within the macula with sparing of foveal pigmentation. Diffuse
increases in hyperpigmentation were located in the periphery of both eyes
(Figure 1). Geographic areas of
hyperfluorescence corresponding to hypopigmented or absent retinal pigment
epithelium (RPE) were present, and the underlying choriocapillaris was perfused
in some areas and nonperfused in other regions (Figure 2).
Borodoker N, Del Priore LV, de A. Carvalho C, Yannuzzi LA. Retinopathy as a Result of Long-term Use of Thioridazine. Arch Ophthalmol. 2002;120(7):994-995. doi:10.1001/archopht.120.7.994