Pan Ying, Keane Pearse A, Sadun Alfredo A, Fawzi Amani A
From the Department of Ophthalmology, Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California.
Retin Cases Brief Rep. 2010 Summer;4(3):229-32. doi: 10.1097/ICB.0b013e3181af7b44.
To describe a 17-year-old boy with β-thalassemia on oral deferasirox, a novel once-daily oral iron chelator, who presented with bilateral painless visual loss, central scotomas, and dyschromatopsia.
Case report.
Fluorescein angiography and full-field electroretinography were normal; initial diagnosis of toxic optic neuropathy secondary to deferasirox was made. However, optical coherence tomography (OCT) revealed no abnormalities in the retinal nerve fiber layer but demonstrated thinning of the outer retina, with disruption of the inner/outer segment (IS/OS) junction in the perifoveal regions in both eyes.
These findings on OCT suggested toxic maculopathy secondary to deferasirox. This case highlights the importance of OCT in the early detection of toxic retinal disorders, especially when other standard tests are nonrevealing. This is the first documented case of deferasirox-induced maculopathy and of deferasirox-related changes demonstrated on OCT.
描述一名17岁患有β地中海贫血的男孩，他正在服用新型每日一次口服铁螯合剂地拉罗司，出现双侧无痛性视力丧失、中心暗点和色觉障碍。
病例报告。
荧光素血管造影和全视野视网膜电图均正常；初步诊断为地拉罗司继发的中毒性视神经病变。然而，光学相干断层扫描（OCT）显示视网膜神经纤维层无异常，但显示外层视网膜变薄，双眼黄斑周围区域内/外节（IS/OS）交界处中断。
OCT上的这些发现提示地拉罗司继发的中毒性黄斑病变。该病例突出了OCT在中毒性视网膜疾病早期检测中的重要性，尤其是在其他标准检查无异常发现时。这是第一例有文献记载的地拉罗司诱导的黄斑病变以及OCT上显示的与地拉罗司相关的变化。
