Weber U, Goerz G, Michaelis L, Melnik B
Univ.-Augenklinik Düsseldorf.
Klin Monbl Augenheilkd. 1988 Jun;192(6):706-11. doi: 10.1055/s-2008-1050209.
Four patients receiving etretinate as long-term therapy were examined. The accumulated dosage was 135 g for Patient 1, about 80 g for Patients 2 and 3, and 31 g etretinate and 4.8 g etretine (Ro 10-1670; main metabolite of etretinate) for Patient 4. Clinical examinations, visual fields (Haitz, Amsler, Goldmann), and EOGs (two patients) were normal. Patient 1 (135 g) showed a decreased level of rod sensitivity at dark adaptation (Goldmann-Weekers), whereas the cone responses were regular in all cases. Furthermore, Patient 1 showed reduced scotopic ERG amplitudes. Aside from this, photopic and scotopic ERGs were normal as far as a- and b-wave amplitudes and peak latencies were concerned. The flicker fusion frequencies were found to be regular. The peak latencies of the R2-component of the early receptor potentials seemed rather short. In all four patients alterations of color sense were analyzed in the Farnsworth Munsell 100 Hue test. The color sense defect seems to originate in the blue-yellow spectrum and--at higher dosages--extends to the red-green spectrum. Examinations with the anomaloscope revealed deuteranomalous settings. Ophthalmological checks for patients receiving long-term aromatic retinoid therapy are recommended, especially with regard to dark adaptation and color sense.
对4例接受阿维A酯长期治疗的患者进行了检查。患者1的累积剂量为135g，患者2和3约为80g，患者4为31g阿维A酯和4.8g阿维A酸（Ro 10-1670；阿维A酯的主要代谢产物）。临床检查、视野检查（海茨、阿姆斯勒、戈德曼）和视网膜电图检查（2例患者）均正常。患者1（135g）在暗适应时（戈德曼-韦克斯）视杆细胞敏感性水平降低，而所有病例中视锥细胞反应均正常。此外，患者1的暗视视网膜电图振幅降低。除此之外，就a波和b波振幅以及峰潜伏期而言，明视和暗视视网膜电图均正常。闪光融合频率正常。早期感受器电位R2成分的峰潜伏期似乎较短。对所有4例患者进行了法恩斯沃思-芒塞尔100色调试验中的色觉分析。色觉缺陷似乎起源于蓝黄色光谱，在更高剂量时会扩展到红绿色光谱。用色觉异常检查镜检查发现有绿色觉异常。建议对接受长期芳香维甲酸治疗的患者进行眼科检查，尤其是关于暗适应和色觉的检查。
