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Methotrimeprazine-induced Corneal Deposits and Cataract Jae-Woong Koh (MD/PhD) Seong-Taeck Kim (MD) Department of Ophthalmology, Chosun University College.

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Presentation on theme: "Methotrimeprazine-induced Corneal Deposits and Cataract Jae-Woong Koh (MD/PhD) Seong-Taeck Kim (MD) Department of Ophthalmology, Chosun University College."— Presentation transcript:

1 Methotrimeprazine-induced Corneal Deposits and Cataract Jae-Woong Koh (MD/PhD) Seong-Taeck Kim (MD) Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Republic of Korea

2 Chosun University College of Medicine Republic of Korea Dr. KohDr. Kim

3 CASE REPORT M / 48 C/C : visual disturbance (Onset : 6 month ago) P/Hx : Medication for Schizophrenia (3 yrs) - 3 mg/day of haloperidol (thioxanthenes family) - 6 mg/day of risperidone (molindone family) Best Corrected Visual Acuity - Right : 20/40 - Left : 20/50

4 CASE REPORT Fine, discrete, and brownish deposits on the posterior cornea

5 CASE REPORT Bilateral star-shaped anterior sub-capsular lens opacities Dense dust-like granular deposits

6 CASE REPORT Patient denied but might have taken the drugs of the phenothiazine family? - Drug Profiling Test by urine samples

7 CASE REPORT Pursing the past history - Patient had taken methotrimeprazine habitually from a different doctor for about 10 years Diagnosis - Drug-induced corneal deposits and cataract Procedure - Phacoemulsification with posterior chamber foldable intra-ocular lens implantation in both eyes Outcome (After 3 years of operation) - Visual acuity improved to 20/20 in both eyes

8 Discussion The uses of Phenothiazines - in schizophrenia - in manic phases of bipolar disorder - in the treatment of nausea (low dose) The Family of Phenothiazine - Chlorpromazine - Methotrimeprazine Long-term medication of phenothiazine - accumulates 50 times higher blood concentration (in the ocular tissue >>> in other tissues of the body)

9 Chlorpromazine-induced Corneal deposits and Cataract Greiner and Berry - First described (1964) - Long-term medication of chlorpromazine - Brown granular pigmentation in cornea - Central star-shaped opacity in the center of anterior capsular lens Can Med Assoc J 1964; 90:663-665

10 Discussion Chlorpromazine-induced Corneal deposits and Cataract - some cases reported However !!! Methotrimeprazine-induced Corneal deposits and Cataract - Unusual and Rare case / specially confirmed by Drug Profiling Test by urine samples

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