Vortex keratopathy hydroxychloroquine

Discussion in 'Reliable Pharmacy' started by FlouraHoork, 26-Feb-2020.

  1. deimosik New Member

    Vortex keratopathy hydroxychloroquine


    The patient had been on Amiodarone therapy for several years. These deposits occur in various levels of the cornea. Two months prior to this routine follow up, the patient's primary care doctor made a change in the patient's cardiac medications which included the removal of amiodarone from his medication regimen. Corneal verticillata, also called vortex keratopathy, are one type of corneal deposits.

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    Toxicity from hydroxychloroquine may be seen in two distinct areas of the eye the cornea and the macula. The cornea may become affected relatively commonly by an innocuous cornea verticillata or vortex keratopathy and is characterized by whorl-like corneal epithelial deposits. These changes bear no relationship to dosage and are usually reversible on cessation of hydroxychloroquine. Cornea verticillata also called vortex keratopathy, whorl keratopathy, or Fleischer vortex describes a whorl-like pattern of golden brown or gray opacities in the cornea. It is termed cornea verticillata from the Latin noun “verticillus,” meaning “whorl”. Toxicity from hydroxychloroquine may be seen in two distinct areas of the eye, the cornea, and the macula. The cornea may become affected relatively commonly by an innocuous vortex keratopathy characterized by whorl-like corneal epithelial deposits.

    The opacities branch out from a central whorl, usually across the inferior cornea. Verticillata are readily recognizable by their distinct appearance as fine, golden-brown or gray opacities that are almost always bilateral.

    Vortex keratopathy hydroxychloroquine

    When OTC is Not OK, Cornea Verticillata - EyeWiki

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  7. Corneal deposits called vortex keratopathy or corneal verticillata result from binding to cellular lipids and deposition of the drug in the basal epithelial layer of the cornea. Discontinuation of the drug usually causes the deposits to disappear over time.

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    Vortex keratopathy corneal verticillata rarely causes vision complaints. In some advanced cases, patients may notice haloes and glare. The deposits occur within the sub-epithelium, do not stain, and are non-irritating. Verticillata appears as bilateral fine, golden-brown or gray opacities in the inferior cornea that branch out from a central. Ocular signs cornea – vortex keratopathy - consists of grayish or golden brown corneal epithelial deposits. They are innocuous, completely reversible & not related to dose or duration. 50% patients may have decreased corneal sensation. They start at a point below the pupil & gradually swirl outwards sparing limbus. The aminoquinolones chloroquine and hydroxychloroquine have been widely used in the treatment of SLE. These drugs can cause a reversible, visually insignificant keratopathy cornea verticillata and, more importantly, an irreversible sight-threatening maculopathy. Clinical progression is of loss of the foveal reflex followed by a fine granular appearance of the macula and finally a “bull's eye” maculopathy presenting as a central scotoma.

     
  8. brainstorm Moderator

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  9. Cumm Well-Known Member

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