Can amiodarone cause corneal deposits?
It is the most common and most well-known ocular adverse effect of amiodarone. On slit lamp exam, one can see corneal deposits in a whorl-like pattern in the inferior cornea bilaterally (see image 1). The deposits are usually a gray or golden-brown color and accumulate in the basal layer of the corneal epithelium.
Why does amiodarone cause corneal deposits?
The ocular effect of amiodarone is vortex keratopathy creating a whorl-like pattern by producing lysosomal deposits in the basal epithelial layer. The whorl-like pattern which was firstly described by Fleischer in 1910 is characterized as powdery, white, yellow, or brown corneal opacities beneath the cornea apex.
What drug causes corneal deposits?
Many different medications can cause corneal deposits (may also be referred to as vortex keratopathy or cornea verticillata). Some of the more common medications include amiodarone, indomethacin, chloroquine, and hydroxychloroquine.
What are the most prevalent eye abnormality in Fabry disease?
The data indicate that cornea verticillata is the most frequently reported eye abnormality in both hemizygotic males and heterozygotic females with Fabry’s disease, and, at present, can be considered the most significant ophthalmological marker for the diagnosis of Fabry’s disease.
Does amiodarone affect your eyes?
Amiodarone use is associated with the development of ocular adverse effects including optic neuropathy (which occurs rarely) and corneal deposits (which occur in most patients). All patients experiencing new or worsening visual symptoms whilst taking amiodarone should be referred for ophthalmological assessment.
What causes corneal verticillata?
Cornea verticillata is often caused by the use of certain systemic medications, the most common of which include amiodarone, chloroquine, hydroxychloroquine, indomethacin, and phenothiazenes. Cornea verticillata can also be seen in the sphingolipidosis, Fabry disease.
How does amiodarone affect the eyes?
How does Fabry disease affect the eyes?
How does Fabry disease affect the eyes? Fabry disease can lead to corneal opacities — grey, brown, or yellowish streaks that appear on the cornea, the clear outer layer that covers the lens of the eye. Sometimes, they first appear as a haze or fog over the cornea, becoming more streak-like with time.
Does amiodarone affect vision?
What are the side effects of amiodarone?
Amiodarone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- constipation.
- loss of appetite.
- headache.
- decreased sex drive.
- difficulty falling asleep or staying asleep.
- flushing.
- changes in ability to taste and smell.
- changes in amount of saliva.
What is Fabry related eye abnormality that can cause blindness?
Cornea verticillata have been described in almost all patients with Fabry disease, both in hemizygous males and heterozygous females. Hence, they are usually considered to be the most reliable ophthalmological marker of Fabry disease.
Can amiodarone cause vision loss?
Amiodarone has also been reported to cause optic neuropathy, which may result in permanent visual loss. The clinical presentation of amiodarone induced optic neuropathy may be similar to that of non-arteritic anterior ischaemic optic neuropathy (NAION).
What causes cornea verticillata in Fabry disease?
Unlike that seen with medications, the cornea verticillata in Fabry disease is caused by a deficiency in alpha-galactosidase A, a lysosomal enzyme. This results in the accumulation of glycosphingolipids in lysosomes throughout body tissues, including the cornea.
Is there a diagnosis for corneal verticillata from amiodarone?
Diagnosis: Corneal Verticillata. EPIDEMIOLOGY. There is no data to suggest protective nor inducing factors in patients who develop verticillata from medication use. Most studies suggest that all or nearly all patients taking amiodarone will develop verticillata.
Which is more common Fabry disease or corneal disease?
Fabry disease is an X-linked recessive disorder and thus most cases involve males. The disease is seen across all racial and ethnic groups approximately equally. Corneal disease: The classic and most common presentation of corneal disease involves the presence of cornea verticillata.
What kind of deposits are found in the cornea?
These deposits occur in various levels of the cornea. Corneal verticillata, also called vortex keratopathy, are one type of corneal deposits. Verticillata are readily recognizable by their distinct appearance as fine, golden-brown or gray opacities that are almost always bilateral.