AN ASYMPTOMATIC 34-year-old man was seen for a routine eye examination. Medical history was noteworthy for a 1-month history of type 2 diabetes mellitus treated with oral hypoglycemic agents. His visual acuity was correctable to 20/15 OU and the intraocular pressure by applanation was 17 mm Hg OD and 16 mm Hg OS. Findings on external ocular examination revealed a normal anatomy with dark tanning of the skin. Findings from the eye examination were completely normal except for numerous bilateral inner retinal crystalline deposits arranged in a doughnut-shaped pattern surrounding the macula (Figure 1). The observed crystalline deposits appeared more pronounced and numerous when evaluated using red-free fundus photography (Figure 2). A fluorescein angiogram showed a perifoveolar ring of blocked fluorescence corresponding to the area of the crystalline deposits (Figure 3). On further discussion with the patient, it was ascertained that he had been taking four 30-mg capsules a day of oral canthaxanthine (Orobronze; DeWitte, Greenville, SC) for the purpose of bronzing his skin.
Espaillat A, Aiello LP, Arrigg PG, Villalobos R, Silver PM, Cavicchi RW. Canthaxanthine Retinopathy. Arch Ophthalmol. 1999;117(3):412. doi:10.1001/archopht.117.3.412