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March 1994

Crystalline Retinopathy Associated With Long-term Nitrofurantoin Therapy

Author Affiliations

St Louis, Mo

Arch Ophthalmol. 1994;112(3):304-305. doi:10.1001/archopht.1994.01090150034012

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Intraretinal crystalline deposition has been seen in association with several systemic and ocular diseases, as well as following exposure to a variety of exogenous drugs and other substances.

We have recently encountered a patient with intraretinal crystals and slightly decreased visual acuity in association with a 19-year history of daily use of nitrofurantoin.

Report of a Case.  A 69-year-old man noted gradual bilateral decrease in vision over 5 to 7 months. His medical history was unremarkable except for benign prostatic hypertrophy and recurrent urinary tract infections treated with nitrofurantoin macrocrystals (Macrodantin), 100mg/d, for 19 years (cumulative dose, 690 g). Best corrected visual acuity was 20/30 OU. Anterior segment examination was unremarkable. Posterior segment evaluation showed bilateral superficial and deep intraretinal glistening deposits distributed in a circinate pattern throughout the posterior pole, sparing the retinal periphery (Figure). Fluorescein angiogram, electroretinogram, and electrooculogram showed no abnormalities. He denied the use of intravenous

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