What drugs cause vortex Keratopathy?
Many different medications can cause corneal deposits (may also be referred to as vortex keratopathy or cornea verticillata). Some of the more common medications include amiodarone, indomethacin, chloroquine, and hydroxychloroquine.
What causes vortex Keratopathy?
It is termed cornea verticillata from the Latin noun “verticillus,” meaning “whorl”. Usually asymptomatic, it is caused by the deposition of medication, material, and disease byproducts in the basal epithelial layer of the cornea.
Is vortex Keratopathy reversible?
Corneal manifestations include vortex keratopathy and decreased corneal sensation. The corneal findings are benign, but the retinal toxicity is concerning, as it is irreversible (even with discontinuation of the drug) and can lead to permanent central and peripheral vision loss.
Which drug causes corneal opacity?
The opacities branch out from a central whorl, usually across the inferior cornea. The most common causes of verticillata include: Amiodarone. Chloroquine and Hydroxychloroquine.
What are Vogt striae?
Vogt’s striae are vertical lines in the posterior stroma of Descemet’s membrane of the cornea. They disappear with pressure applied to the cornea. Vogt’s striae have been reported to be horizontal in only two cases in the literature. Vogt’s striae are a feature of keratoconus, but they are also found in healthy eyes.
Does amiodarone affect vision?
Amiodarone use is associated with the development of ocular adverse effects including optic neuropathy (which occurs rarely) and corneal deposits (which occur in most patients). All patients experiencing new or worsening visual symptoms whilst taking amiodarone should be referred for ophthalmological assessment.
Does vortex Keratopathy affect vision?
Vortex keratopathy is the most common (70–100%) ocular change caused by amiodarone. Although the most common findings are corneal, lens opacities and optic neuropathy have also been reported due to amiodarone. In the current cases, lens changes and retinal changes were not observed.
Can amiodarone cause corneal deposits?
Amiodarone use is associated with the development of ocular adverse effects including optic neuropathy (which occurs rarely) and corneal deposits (which occur in most patients).
Can amiodarone cause Keratopathy?
The ocular effect of amiodarone is vortex keratopathy creating a whorl-like pattern by producing lysosomal deposits in the basal epithelial layer. The whorl-like pattern which was firstly described by Fleischer in 1910 is characterized as powdery, white, yellow, or brown corneal opacities beneath the cornea apex.
Is corneal opacity curable?
Treatment may include patching the eye, using a temporary contact lens, and prescription eye drops or ointments. If vision problems remain or the cornea becomes permanently damaged, you may need a cornea transplant. This surgery removes the damaged cornea and replaces it with a healthy donor cornea.
What causes Vogt striae?
Striae can be attributed to undulations, not ruptures, in continuous collagen lamellae of the stroma. Lamellae are 1-3 µm thick. The undulations originate at Descemet’s membrane and travel through the corneal stroma toward Bowman’s layer.
What is granular dystrophy?
Granular corneal dystrophy is the slow forming of deposits in the middle layer of the cornea, which can lead to vision impairment and discomfort. Symptoms include decreased vision and eye discomfort or pain.
What is cornea verticillata ( vortex keratopathy)?
Cornea verticillata or vortex keratopathy was first described by François,1 who noted a whorl-like pattern associated with chloroquine, amiodarone, and Fabry’s disease.
What drugs can cause vortex keratopathy?
A host of cationic amphiphilic drugs, such as chloroquine, tamoxifen, suramin and clofazimine, may also result in a drug-induced lipidosis and produce a vortex keratopathy, Dr. Pepose says. This vortex pattern has been reported with some very common drugs, such as ibuprofen and indomethacin, he adds.
Can atovaquone cause vortex keratopathy?
Atovaquone and isotretinoin are other drugs that may cause such a keratopathy, two separate studies found. 2,3 This is also due to the lipophilic properties of both drugs. You can also differentiate between drug-induced vortex keratopathy and other causes by modifying the patients medicine regimen and monitoring the results.
What are the best management options for vortex keratopathy caused by amiodarone?
Q: A 72-year-old patient who uses amiodarone for a cardiac condition presented with vortex keratopathy, reduced visual acuity and significant glare. What are the best management options? A: First, contact the patients cardiologist or primary-care physician (PCP). Find out if the medication can be adjusted, says Paul Karpecki, O.D., of Edgewood, Ky.
