Yıl: 2023 Cilt: 7 Sayı: 1 Sayfa Aralığı: 11 - 18 Metin Dili: Türkçe DOI: 10.37783/CRJ-0333 İndeks Tarihi: 17-05-2023

Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin)

Öz:
Toksik retinopatiler, sistemik olarak uygulanan ilaçların neden olduğu retina hasarından kaynaklanan çeşitli durumlardır. Nispeten nadir olmalarına rağmen, özellikle iki taraflı pigmenter bozukluk veya retinada kristal birikimi gibi olağan dışı bir retinopati veya makulopati özellikleri mevcut olduğunda, göz önünde bulundurulmalıdır. Birtakım ilaçların RPE ve fotoreseptör tabakasında hasar yaptığı gözlenmiştir. Bunlardan klofazimin; tüberküloz, lepra ve çeşitli kutanöz hastalıkların tedavisinde kullanılabilmekte ancak doza bağımlı olarak renkli görme defekti ile öküz gözü makulopatiye sebep olabilmektedir. Demir şelatlayıcı ajan olarak kullanılan deferoksamin mesilat kullanımıyla ilişkili çeşitli görüntüleme yöntemleriyle saptanabilen lezyonlar tanımlanmıştır. Kseroftalmi semptomlarıyla karakterize A vitamini eksikliğinde rod fonksiyon defektlerinin ön planda olduğu, fotoreseptör dış segmentte druzenoid birikintiler gözlenmiştir. Teropatik aralığı oldukça dar olan digoksin kullanımında ise yine renk algısında bozulmayla kendisini gösteren fotoreseptör fonksiyon bozuklukları gelişebilmektedir. Sistemik ilaç kullanımına bağlı oküler yan etkilerin çoğu, erken tespit edilirse, tedavinin kesilmesinden sonra geri dönüşümlüdür. Bununla birlikte, toksik etkiler tespit edilmezse ilerleyebilir ve potansiyel olarak geri dönüşü olmayan görme kaybı ile ilişkili retinal disfonksiyona neden olabilir.
Anahtar Kelime:

Medications Damaging Retinal Pigment Epithelium and Photoreceptor Complex-3: Pathogenesis, Diagnosis and Treatment (Clofazimine, Deferoxamine, Vitamin A Deficiency and Celiac Disease, Digoxin)

Öz:
Toxic retinopathies are a variety of conditions resulting from retinal damage caused by systemically administered drugs. Although relatively rare, these conditions should be considered, especially when features of unusual retinopathy or maculopathy such as bilateral pigmentary disorder or retinal crystal deposition are present. It has been observed that some drugs damage the RPE and photoreceptor layer. Of these drugs, clofazimine; can be used in the treatment of tuberculosis, leprosy, and various cutaneous diseases, but it can cause color vision defects and bulls-eye maculopathy in a dose-dependent manner. Lesions detectable by various imaging methods have been described as associated with the use of deferoxamine mesylate, which is used as an iron chelating agent. In vitamin A deficiency characterized by xerophthalmia symptoms, drusenoid deposits has been observed in the photoreceptor outer segment, in which rod function defects are prominent. In the use of digoxin, which has a very narrow therapeutic range, photoreceptor dysfunctions, which are manifested by deterioration in color perception, may develop. Most ocular side effects associated with systemic drug use are reversible after discontinuation of therapy if detected early. However, toxic effects can progress if undetected and cause retinal dysfunction associated with potentially irreversible vision loss.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Bibliyografik
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  • 1. Patrick D, William C. Retinal Toxicity of Systemic Medications. Daniel M. Albert, Loan W. Miller, Dimitri T. Azar (eds), Albert and Jakobiec’s principles & practice of ophthalmology, 4th Edition, Sauders, London , Elsevier 2008:2213-2221.
  • 2. Cunningham CA, Friedberg DN, Carr RE. Clofazamine-induced generalized retinal degeneration. Retina. 1990;10(2):131-134.
  • 3. Kasturi N, Srinivasan R. Clofazimine-induced premaculopathy in a vitiliginous patient. Journal of pharmacology & pharmacotherapeutics. 2016;7(3):149-151.
  • 4. Mirnejad R, Asadi A, Khoshnood S, et al. Clofazimine: A useful antibiotic for drug-resistant tuberculosis. Biomedicine & Pharmacotherapy. 2018;105:1353-1359.
  • 5. Cholo MC, Mothiba MT, Fourie B, Anderson R. Mechanisms of action and therapeutic efficacies of the lipophilic antimycobacterial agents clofazimine and bedaquiline. The Journal of antimicrobial chemotherapy. 2017; 72(2):338-353.
  • 6. Cholo MC, Steel HC, Fourie PB, Germishuizen WA, Anderson R. Clofazimine: current status and future prospects. The Journal of antimicrobial chemotherapy. 2012;67(2):290-298.
  • 7. Forster DJ, Causey DM, Rao NA. Bull’s eye retinopathy and clofazimine. Annals of internal medicine. 1992;116(10):876-877.
  • 8. Barot RK, Viswanath V, Pattiwar MS, Torsekar RG. Crystalline deposition in the cornea and conjunctiva secondary to long-term clofazimine therapy in a leprosy patient. Indian J Ophthalmol. 2011;59(4):328-329.
  • 9. Kaur I, Ram J, Kumar B, Kaur S, Sharma VK. Effect of clofazimine on eye in multibacillary leprosy. Indian journal of leprosy. 1990;62(1):87-90.
  • 10. Craythorn JM, Swartz M, Creel DJ. Clofazimine-induced bull’s-eye retinopathy. Retina. 1986;6(1):50-52.
  • 11. Brittenham GMJNEJoM. Iron-chelating therapy for transfusional iron overload. N Engl J Med. 2011; 364(2):146-156.
  • 12. Nakamura H, Rose PG, Blumer JL, Reed MDJTJoCP. Acute encephalopathy due to aluminum toxicity successfully treated by combined intravenous deferoxamine and hemodialysis. J Clin Pharmacol. 2000;40(3):296-300.
  • 13. Velasquez J, Wray AA. Deferoxamine. StatPearls [Internet]; Stat- Pearls Publishing; 2020.
  • 14. Chen S-H, Liang D-C, Lin H-C, Cheng S-Y, Chen L-J, Liu H-CJJoPHO. Auditory and visual toxicity during deferoxamine therapy in transfusion-dependent patients.J Pediatr Hematol Oncol. 2005; 27(12):651-653.
  • 15. Chan Y-L, Chu C-wW, Chik K-W, Pang L-M, Shing M-K, Li C-K. Deferoxamine induced dysplasia of the knee: sonographic features and diagnostic performance compared with magnetic resonance imaging. J Ultrasound Med. 2001; 20(7):723-728.
  • 16. BAATH JS, LAM W-C, KIRBY M, CHUN A. DEFEROXAMINE- RELATED OCULAR TOXICITY: Incidence and Outcome in a Pediatric Population. Retina. 2008; 28(6):894-899.
  • 17. Di Nicola M, Barteselli G, Dell’Arti L, Ratiglia R, Viola F. Functional and Structural Abnormalities in Deferoxamine Retinopathy: A Review of the Literature. BioMed Research International. 2015; 2015:249617.
  • 18. Haimovici R, D’Amico DJ, Gragoudas ES, Sokol S, Ophthalmology DRSGJ. The expanded clinical spectrum of deferoxamine retinopathy. Ophthalmology.2002;109(1):164-171.
  • 19. Rahi A, Hungerford J, Ahmed AJBjoo. Ocular toxicity of desferrioxamine: light microscopic histochemical and ultrastructural findings. Br J Ophthalmol. 1986;70(5):373-381.
  • 20. De Virgiliis S, Congia M, Turco MP et al. Depletion of trace elements and acute ocular toxicity induced by desferrioxamine in patients with thalassaemia. Arch Dis Child. 1988;63(3):250-255.
  • 21. Klettner A, Koinzer S, Waetzig V, Herdegen T, Roider JJC, toxicology o. Deferoxamine mesylate is toxic for retinal pigment epithelium cells in vitro, and its toxicity is mediated by p38. Cutan Ocul Toxicol. 2010;29(2):122-129.
  • 22. Lakhanpal V, Schocket SS, Jiji R. Deferoxamine (Desferal®)-induced Toxic Retinal Pigmentary Degeneration and Presumed Optic Neuropathy. Ophthalmology. 1984; 91(5):443-451.
  • 23. Bansal V, Elgarbly I, Ghanchi F, Atkinson PJEjoh. Bull’s eye maculopathy with deferoxamine. Eur J Haematol. 2003;70(6):420-421.
  • 24. Viola F, Barteselli G, Dell’Arti L et al. Abnormal fundus autofluorescence results of patients in long-term treatment with deferoxamine. Ophthalmology.2012; 119(8):1693-1700.
  • 25. Wu C-H, Yang C-P, Lai C-C, Wu W-C, Chen Y-HJBo. Deferoxamine retinopathy: spectral domain-optical coherence tomography findings. BMC Ophthalmol. 2014;14(1):1-3.
  • 26. Genead MA, Fishman GA, Anastasakis A, Lindeman MJDo. Macular vitelliform lesion in desferrioxamine-related retinopathy. Doc Ophthalmol. 2010; 121(2):161-166.
  • 27. Simon S, Athanasiov PA, Jain R, Raymond G, Gilhotra JSJIjoo. Desferrioxamine-related ocular toxicity: a case report.Indian J Ophthalmol. 2012; 60(4):315.
  • 28. Gonzales CR, Lin AP, Engstrom RE, Kreiger AE. BILATERAL VITELLIFORM MACULOPATHY AND DEFEROXAMINE TOXICITY. RETINA. 2004;24(3):464-467.
  • 29. Hidajat RR, McLay JL, Goode DH, Spearing RL. EOG as a monitor of desferrioxamine retinal toxicity. Documenta Ophthalmologica. 2004; 109(3):273-278.
  • 30. Bui KM, Sadda SR, Salehi-Had H. Pseudovitelliform maculopathy associated with deferoxamine toxicity: multimodal imaging and electrophysiology of a rare entity. Digit J Ophthalmol. 2017; 23(1):11-15.
  • 31. R AL, M M. Retinal Toxicity of Systemically Administered Drugs. Myron Yanoff and Jay S. Duker: Ophthalmology. USA: Springer; 2019: 683-687.
  • 32. Rubio-Tapia A, Ludvigsson JF, Brantner TL, Murray JA, Everhart JEJOjotACoG, ACG. The prevalence of celiac disease in the United States. 2012; 107(10):1538-44.
  • 33. Lebwohl B, Sanders DS, Green PHR. Coeliac disease. The Lancet. 2018; 391(10115):70-81.
  • 34. Glissen Brown JR, Singh P. Coeliac disease. Paediatrics and International Child Health. 2019; 39(1):23-31.
  • 35. Martins TG, Costa AL, Oyamada MK, Schor P, Sipahi AM. Ophthalmologic manifestations of celiac disease. Int J Ophthalmol. 2016;9(1):159-162.
  • 36. Fousekis FS, Katsanos A, Katsanos KH, Christodoulou DK. Ocular manifestations in celiac disease: an overview. Int Ophthalmol. 2020; 40(4):1049-54.
  • 37. Tokgöz Y, Terlemez S, Krul A. Fat soluble vitamin levels in children with newly diagnosed celiac disease, a case control study. BMC pediatrics. 2018; 18(1):130.
  • 38. Dotan G, Goldstein M, Stolovitch C, Kesler A. Pediatric Pseudotumor Cerebri Associated With Low Serum Levels of Vitamin A. J Child Neurol. 2013; 28(11):1370-1377.
  • 39. Sherwin JC, Reacher MH, Dean WH, Ngondi J. Epidemiology of vitamin A deficiency and xerophthalmia in at-risk populations. Trans R Soc Trop Med Hyg. 2012; 106(4):205-214.
  • 40. Wiseman EM, Bar-El Dadon S, Reifen R. The vicious cycle of vitamin a deficiency: A review. Crit Rev Food Sci Nutr.2017; 57(17):3703-3714.
  • 41. Saenz-de-Viteri M, Sádaba LM. Optical Coherence Tomography Assessment Before and After Vitamin Supplementation in a Patient With Vitamin A Deficiency: A Case Report and Literature Review. Medicine. 2016; 95(6):e2680.
  • 42. Marmor MF. Retinal Pigment Epitelium . Myron Yanoff and Jay S. Duker: Ophthalmology. USA: Springer; 2019: 423-425.
  • 43. Smith J, Steinemann TL. Vitamin A Deficiency and the Eye. Int Ophthalmol Clin. 2000;40(4):83-91.
  • 44. Stroh C, Weiher C, Hohmann U, Meyer F, Lippert H, Manger TJOs. Vitamin A deficiency (VAD) after a duodenal switch procedure: a case report.Obes Surg. 2010; 20(3):397-400.
  • 45. Berkenstock MK, Castoro CJ, Carey AR. Outer retina changes on optical coherence tomography in vitamin A deficiency. Int J Retina Vitreous. 2020; 6:23.
  • 46. Feroze KB, Kaufman EJ. Xerophthalmia StatPearls Publishing, Treasure Island (FL); 2021.
  • 47. Farrell MC, Weiss SJ, Goodrich C, Martinez Lehmann MP, Delarato N. Food Aversion Leading to Nutritional Optic Neuropathy in a Child With Severe Vitamin A Deficiency. J Neuroophthalmol. 2021; 41(4):e718-719.
  • 48. O’Neill EK, Smith R. Visual electrophysiology in the assessment of toxicity and deficiency states affecting the visual system. Eye (London, England). 2021; 35(9):2344-2353.
  • 49. Lee A, Tran N, Monarrez J, Mietzner D. Case Report: Vitamin A Deficiency and Nyctalopia in a Patient with Chronic Pancreatitis. Optom Vis Sci. 2019; 96(6):453-458.
  • 50. Saker S, Morales M, Jhittay H, Wen Y, Amoaku W. Electrophysiological and microperimetry changes in vitamin A deficiency retinopathy. Doc Ophthalmol. 2015; 130(3):231-240.
  • 51. Aleman TS, Garrity ST, Brucker AJ. Retinal structure in vitamin A deficiency as explored with multimodal imaging. Doc Ophthalmol. 2013; 127(3):239-243.
  • 52. McBain VA, Egan CA, Pieris SJ, Supramaniam G, Webster AR, Bird AC, Holder GE. Functional observations in vitamin A deficiency: diagnosis and time course of recovery. Eye (London, England). 2007; 21(3):367-376.
  • 53. Lee WB, Hamilton SM, Harris JP, Schwab IR. Ocular Complications of Hypovitaminosis A after Bariatric Surgery. Ophthalmology. 2005; 112(6):1031-1034.
  • 54. Berkenstock MK, Castoro CJ, Carey AR. Outer retina changes on optical coherence tomography in vitamin A deficiency. Int J Retina Vitreous. 2020; 6(1):23.
  • 55. Ellis MP, Chang MY, Yiu G. Anti-Retinal Antibodies in Vitamin A Deficiency. Ophthalmic Surg Lasers Imaging Retina.2020; 51(12):723-6.
  • 56. Ten Hulzen RD, Wagner IV, Decastro PY, Sullivan JP. Visual field decline and restoration following vitamin A therapy for vitamin A deficiency. Am J Ophthalmol Case Rep. 2022; 26:101471.
  • 57. Remolí Sargues L, Montero Hernández J, Ortiz Salvador M et al. Vitamin A retinopathy secondary to Billroth II anastomosis triggered after the beginning of dialysis. Eur J Ophthalmol. 2021:11206721211027416.
  • 58. Hollman A. Drugs for atrial fibrillation. Digoxin comes from Digitalis lanata. BMJ (Clinical research ed). 1996; 312(7035):912.
  • 59. David, Marie Nicole V., and Mrin Shetty. Digoxin. 2020.
  • 60. Renard D, Rubli E, Voide N, Borruat F-X, Rothuizen LE. Spectrum of digoxin-induced ocular toxicity: a case report and literature review. BMC research notes. 2015;8(1):368.
  • 61. Currie GM, Wheat JM, Kiat H. Pharmacokinetic considerations for digoxin in older people. Open Cardiovasc Med J. 2011; 5:130- 5.
  • 62. Bryant B, Knights K. Pharmacology for Health Professionals ebook Elsevier Health Sciences; 2014.
  • 63. Dettoraki M, Moschos MM. The Role of Multifocal Electroretinography in the Assessment of Drug-Induced Retinopathy: A Review of the Literature. Ophthalmic Res.2016; 56:169-177.
  • 64. Renard D, Rubli E, Voide N, Borruat FX, Rothuizen LE. Spectrum of digoxin-induced ocular toxicity: a case report and literature review. BMC research notes. 2015; 8:368.
  • 65. Lawrenson J, Kelly C, Lawrenson A, Birch JJBjoo. Acquired colour vision deficiency in patients receiving digoxin maintenance therapy. Br J Ophthalmol. 2002; 86(11):1259-1261.
  • 66. Landfried B, Samardzija M, Barben M et al. Digoxin-induced retinal degeneration depends on rhodopsin. Cell Death Dis. 2017; 8(3):e2670.
  • 67. Madreperla SA, Johnson MA, Nakatani KJAoO. Electrophysiologic and electroretinographic evidence for photoreceptor dysfunction as a toxic effect of digoxin. Arch Ophthalmol. 1994; 112(6):807-812.
  • 68. Capellan P, Mahrous MA, Kovacs KD. OCT Findings in Presumed Digoxin Retinal Toxicity. Ophthalmology Retina. 2021; 5(11):1173-1175.
  • 69. Hinshaw SJ, Ogbeifun O, Wandu WS et al. Digoxin Inhibits Induction of Experimental Autoimmune Uveitis in Mice, but Causes Severe Retinal Degeneration.Invest Ophthalmol Vis Sci. 2016; 57(3):1441-1447.
  • 70. Yoshida T, Zhang H, Iwase T, Shen J, Semenza GL, Campochiaro PA. Digoxin inhibits retinal ischemia-induced HIF-1alpha expression and ocular neovascularization. FASEB J. 2010;24(6):1759- 1767.
  • 71. Winter U, Buitrago E, Mena HA et al. Pharmacokinetics, Safety, and Efficacy of Intravitreal Digoxin in Preclinical Models for Retinoblastoma. Invest Ophthalmol Vis Sci.2015; 56(8):4382-4393.
APA meşen s, meşen a, Batur M (2023). Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin). , 11 - 18. 10.37783/CRJ-0333
Chicago meşen selma,meşen ali,Batur Muhammed Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin). (2023): 11 - 18. 10.37783/CRJ-0333
MLA meşen selma,meşen ali,Batur Muhammed Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin). , 2023, ss.11 - 18. 10.37783/CRJ-0333
AMA meşen s,meşen a,Batur M Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin). . 2023; 11 - 18. 10.37783/CRJ-0333
Vancouver meşen s,meşen a,Batur M Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin). . 2023; 11 - 18. 10.37783/CRJ-0333
IEEE meşen s,meşen a,Batur M "Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin)." , ss.11 - 18, 2023. 10.37783/CRJ-0333
ISNAD meşen, selma vd. "Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin)". (2023), 11-18. https://doi.org/10.37783/CRJ-0333
APA meşen s, meşen a, Batur M (2023). Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin). Güncel Retina Dergisi, 7(1), 11 - 18. 10.37783/CRJ-0333
Chicago meşen selma,meşen ali,Batur Muhammed Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin). Güncel Retina Dergisi 7, no.1 (2023): 11 - 18. 10.37783/CRJ-0333
MLA meşen selma,meşen ali,Batur Muhammed Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin). Güncel Retina Dergisi, vol.7, no.1, 2023, ss.11 - 18. 10.37783/CRJ-0333
AMA meşen s,meşen a,Batur M Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin). Güncel Retina Dergisi. 2023; 7(1): 11 - 18. 10.37783/CRJ-0333
Vancouver meşen s,meşen a,Batur M Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin). Güncel Retina Dergisi. 2023; 7(1): 11 - 18. 10.37783/CRJ-0333
IEEE meşen s,meşen a,Batur M "Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin)." Güncel Retina Dergisi, 7, ss.11 - 18, 2023. 10.37783/CRJ-0333
ISNAD meşen, selma vd. "Retina Pigment Epiteli ve Fotoreseptör Kompleksinde Hasar Yapan İlaçlar-3: Patogenez, Tanı ve Tedavi (Klofazimin, Deferoksamin, A Vitamini Eksikliği ve Çölyak Hastalığı, Digoksin)". Güncel Retina Dergisi 7/1 (2023), 11-18. https://doi.org/10.37783/CRJ-0333