Faure Céline, Audo Isabelle, Zeitz Christina, Letessier Jean-Bernard, Robert Matthieu P
Ophtalmologie, Hôpital Privé Saint Martin, 18 rue des Roquemonts, 14000, Caen, France,
Doc Ophthalmol. 2015 Aug;131(1):35-41. doi: 10.1007/s10633-015-9494-x. Epub 2015 Mar 20.
To report the first documented case of aripiprazole-induced chorioretinopathy.
A 47-year-old schizophrenic patient with loss of vision due to an atypical retinopathy was investigated. She had been treated with aripiprazole for 8 years. Multimodal imaging showed in the right eye a large area of retinal atrophy predominating in the outer retina, including the posterior pole up to the upper temporal periphery, and in the left eye a serous retinal detachment. The electroretinogram exhibited decreased and delayed responses of both the rod and cone systems; the electrooculogram showed no light peak.
Aripiprazole, an atypical antipsychotic, was introduced more recently than the antipsychotics commonly incriminated in chorioretinopathies, such as thioridazine. Optical coherence tomography was not used to document former cases of antipsychotic-related chorioretinopathies. Although pathophysiological mechanisms are poorly understood, imaging of the present case points toward an involvement of the retinal pigmentary epithelium. Clinicians should be aware of the potential chorioretinal toxicity of new atypical antipsychotics.
报告首例有文献记载的阿立哌唑诱发脉络膜视网膜病变的病例。
对一名47岁因非典型视网膜病变而视力丧失的精神分裂症患者进行了调查。她接受阿立哌唑治疗已8年。多模态成像显示右眼有一大片视网膜萎缩区域，主要在外视网膜，包括后极直至颞上周边；左眼有浆液性视网膜脱离。视网膜电图显示视杆和视锥系统反应均降低且延迟；眼电图未显示光峰。
阿立哌唑作为一种非典型抗精神病药物，其应用时间比通常被认为与脉络膜视网膜病变有关的抗精神病药物（如硫利达嗪）更近。以往抗精神病药物相关脉络膜视网膜病变的病例未使用光学相干断层扫描进行记录。尽管病理生理机制尚不清楚，但本病例的影像学表现提示视网膜色素上皮受累。临床医生应意识到新型非典型抗精神病药物潜在的脉络膜视网膜毒性。
