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Methotrimeprazine-induced Corneal Deposits and Cataract

Methotrimeprazine-induced Corneal Deposits and Cataract. Jae-Woong Koh (MD/PhD) Seong-Taeck Kim (MD) Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Republic of Korea. Dr. Koh. Dr. Kim. Chosun University College of Medicine Republic of Korea. CASE REPORT.

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Methotrimeprazine-induced Corneal Deposits and Cataract

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  1. Methotrimeprazine-induced Corneal Deposits and Cataract Jae-Woong Koh (MD/PhD) Seong-Taeck Kim (MD) Department of Ophthalmology, Chosun University College of Medicine,Gwangju, Republic of Korea

  2. Dr. Koh Dr. Kim Chosun University College of MedicineRepublic of Korea

  3. CASE REPORT • M / 48 • C/C : visual disturbance (Onset : 6 month ago) • P/Hx : Medication for Schizophrenia (3 yrs)- 3 mg/day of haloperidol (thioxanthenes family)- 6 mg/day of risperidone (molindone family) • Best Corrected Visual Acuity - Right : 20/40- Left : 20/50

  4. Fine, discrete, and brownish deposits on the posterior cornea CASE REPORT

  5. Bilateral star-shaped anterior sub-capsular lens opacities Dense dust-like granular deposits CASE REPORT

  6. CASE REPORT • Patient denied but might have taken the drugs of the phenothiazine family?- Drug Profiling Test by urine samples

  7. CASE REPORT • Pursing the past history- Patient had taken methotrimeprazine habitually from a different doctor for about 10 years • Diagnosis- Drug-induced corneal deposits and cataract • Procedure- Phacoemulsification with posterior chamber foldable intra-ocular lens implantation in both eyes • Outcome (After 3 years of operation)- Visual acuity improved to 20/20 in both eyes

  8. Discussion • The uses of Phenothiazines - in schizophrenia- in manic phases of bipolar disorder- in the treatment of nausea (low dose) • The Family of Phenothiazine- Chlorpromazine- Methotrimeprazine • Long-term medication of phenothiazine- accumulates 50 times higher blood concentration (in the ocular tissue >>> in other tissues of the body)

  9. Chlorpromazine-induced Corneal deposits and Cataract • Greiner and Berry- First described (1964)- Long-term medication of chlorpromazine- Brown granular pigmentation in cornea - Central star-shaped opacity in the center of anterior capsular lens Can Med Assoc J 1964; 90:663-665

  10. Discussion • Chlorpromazine-induced Corneal deposits and Cataract - some cases reported • However !!!Methotrimeprazine-induced Corneal deposits and Cataract- Unusual and Rare case / specially confirmed by Drug Profiling Test by urine samples

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