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Amiodarone Keratopathy: Drug-Induced Lipid Storage Disease

Amiodarone Keratopathy: Drug-Induced Lipid Storage Disease Abstract • Therapeutic administration of amiodarone, an antiarrhythmic drug, to eight patients resulted in the formation of vortex-like figures within the anterior cornea. Clinical examination disclosed no visual loss or other ocular abnormality attributable to the drug. In one patient, light and transmission electron microscopy of corneal epithelium, bulbar conjunctiva, and cataractous lens revealed complex lipid deposits within lysosome-like intracytoplasmic inclusions in corneal, conjunctival, and lens epithelium, conjunctival fibrocytes, and conjunctival vascular endothelium. Amiodarone keratopathy is compared clinically and morphologically with the corneal alterations seen in Fabry's disease and in chloroquine use as an example of a drug-induced lipid storage disorder. References 1. Rosenbaum MB, Chiale PA, Halpern MS, et al: Clinical efficacy of amiodarone as an antiarrhythmic agent . Am J Cardiol 38:934-944, 1976.Crossref 2. Rosenbaum MB, Chiale PA, Ryba D, et al: Control of tachyarrhythmias associated with Wolff-Parkinson-White syndrome by amiodarone hydrochloride . Am J Cardiol 34:215-223, 1974.Crossref 3. Zipes DP, Troup PJ: New antiarrhythmic agents: Amiodarone, aprindine, disopyramide, ethmozin, mexiletine, tocainide, verapamil . Am J Cardiol 41:1005-1024, 1978.Crossref 4. Francois J: Cornea verticillata . Bull Soc Belge Ophtalmol 150:656-670, 1968. 5. Thilges V: Le cordarone, cause de microdépots de l'épithélium corneen semblables à ceux de l'intoxication chloriquinique . Ann Ocul 203:151-157, 1970. 6. Babel J, Stangos N: Lésions oculaires iatrogènes: L'action d'un nouveau médicament contre l'angor pectoris . Arch Ophtal 30:197-208, 1970. 7. Watillon M, Lavergne G, Weekers JF: Lésions cornéenes au cours du traitement par le cordarone (chlorhydrate d'amiodarone) . Bull Soc Belge Ophtalmol 150:715-726, 1968. 8. Déodati F, Bec P, Cuq G, et al: Thésaurisomose cornéene par traitement au chlorhydrate d'amiodarone: A propos de 13 observations . Bull Soc Ophtalmol Fr 69:967-973, 1969. 9. Peyresblanques J: Kératopathie par cordarone . Bull Soc Ophtalmol Fr 69:973-977, 1969. 10. Toussaint D, Pohl S: Aspect hitologique et ultrastructure des depots corneens dus au chlorhydrate d'amiodarone . Bull Soc Belge Ophtalmol 153:675-686, 1969. 11. Libert J: Diagnostic des malades lysosomiales de stockage par l'étude de la biopsie conjonctivale en microscope éléctronique, thesis. Brussels, 1979. 12. Kenyon KR: Ocular ultrastructure of inherited metabolic disease , in Golderg F (ed): Genetic and Metabolic Eye Disease . Boston, Little Brown & Co, 1974, pp 139-185. 13. Pülhorn G, Thiel HJ: Das ultrastrukturelle Bild der Chloroquin Keratopathie . Albrecht Von Graefes Arch Klin Exp Ophthalmol 201:89, 1976.Crossref 14. Bockhardt H, Drenckhahn D, Lüllmann-Rauch R: Amiodarone-induced-lipidosis-like alterations in ocular tissues of rats . Albrecht Von Graefes Arch Klin Exp Ophthalmol 207:91, 1978.Crossref 15. Lüllmann H, Lüllmann-Rauch R, Wassermann O: Lipidosis induced by amphiphilic cationic drugs . Biochem Pharmacol 27:1103, 1978.Crossref 16. Lüllmann H, Lüllmann-Rauch R, Wasserman O: Drug-induced phospholipidoses: II. Tissue distribution of the amphiphilic drug chlorphentermine . CRC Crit Rer Toxicol 4:185-218, 1975. 17. Weiss JN, Weinberg RS, Regelson W: Keratopathy after oral administration of tilorone hydrochloride . Am J Ophthalmol 89:46-53, 1980. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Amiodarone Keratopathy: Drug-Induced Lipid Storage Disease

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References (17)

Publisher
American Medical Association
Copyright
Copyright © 1981 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1981.03930010259007
Publisher site
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Abstract

Abstract • Therapeutic administration of amiodarone, an antiarrhythmic drug, to eight patients resulted in the formation of vortex-like figures within the anterior cornea. Clinical examination disclosed no visual loss or other ocular abnormality attributable to the drug. In one patient, light and transmission electron microscopy of corneal epithelium, bulbar conjunctiva, and cataractous lens revealed complex lipid deposits within lysosome-like intracytoplasmic inclusions in corneal, conjunctival, and lens epithelium, conjunctival fibrocytes, and conjunctival vascular endothelium. Amiodarone keratopathy is compared clinically and morphologically with the corneal alterations seen in Fabry's disease and in chloroquine use as an example of a drug-induced lipid storage disorder. References 1. Rosenbaum MB, Chiale PA, Halpern MS, et al: Clinical efficacy of amiodarone as an antiarrhythmic agent . Am J Cardiol 38:934-944, 1976.Crossref 2. Rosenbaum MB, Chiale PA, Ryba D, et al: Control of tachyarrhythmias associated with Wolff-Parkinson-White syndrome by amiodarone hydrochloride . Am J Cardiol 34:215-223, 1974.Crossref 3. Zipes DP, Troup PJ: New antiarrhythmic agents: Amiodarone, aprindine, disopyramide, ethmozin, mexiletine, tocainide, verapamil . Am J Cardiol 41:1005-1024, 1978.Crossref 4. Francois J: Cornea verticillata . Bull Soc Belge Ophtalmol 150:656-670, 1968. 5. Thilges V: Le cordarone, cause de microdépots de l'épithélium corneen semblables à ceux de l'intoxication chloriquinique . Ann Ocul 203:151-157, 1970. 6. Babel J, Stangos N: Lésions oculaires iatrogènes: L'action d'un nouveau médicament contre l'angor pectoris . Arch Ophtal 30:197-208, 1970. 7. Watillon M, Lavergne G, Weekers JF: Lésions cornéenes au cours du traitement par le cordarone (chlorhydrate d'amiodarone) . Bull Soc Belge Ophtalmol 150:715-726, 1968. 8. Déodati F, Bec P, Cuq G, et al: Thésaurisomose cornéene par traitement au chlorhydrate d'amiodarone: A propos de 13 observations . Bull Soc Ophtalmol Fr 69:967-973, 1969. 9. Peyresblanques J: Kératopathie par cordarone . Bull Soc Ophtalmol Fr 69:973-977, 1969. 10. Toussaint D, Pohl S: Aspect hitologique et ultrastructure des depots corneens dus au chlorhydrate d'amiodarone . Bull Soc Belge Ophtalmol 153:675-686, 1969. 11. Libert J: Diagnostic des malades lysosomiales de stockage par l'étude de la biopsie conjonctivale en microscope éléctronique, thesis. Brussels, 1979. 12. Kenyon KR: Ocular ultrastructure of inherited metabolic disease , in Golderg F (ed): Genetic and Metabolic Eye Disease . Boston, Little Brown & Co, 1974, pp 139-185. 13. Pülhorn G, Thiel HJ: Das ultrastrukturelle Bild der Chloroquin Keratopathie . Albrecht Von Graefes Arch Klin Exp Ophthalmol 201:89, 1976.Crossref 14. Bockhardt H, Drenckhahn D, Lüllmann-Rauch R: Amiodarone-induced-lipidosis-like alterations in ocular tissues of rats . Albrecht Von Graefes Arch Klin Exp Ophthalmol 207:91, 1978.Crossref 15. Lüllmann H, Lüllmann-Rauch R, Wassermann O: Lipidosis induced by amphiphilic cationic drugs . Biochem Pharmacol 27:1103, 1978.Crossref 16. Lüllmann H, Lüllmann-Rauch R, Wasserman O: Drug-induced phospholipidoses: II. Tissue distribution of the amphiphilic drug chlorphentermine . CRC Crit Rer Toxicol 4:185-218, 1975. 17. Weiss JN, Weinberg RS, Regelson W: Keratopathy after oral administration of tilorone hydrochloride . Am J Ophthalmol 89:46-53, 1980.

Journal

Archives of Ophthalmology – American Medical Association

Published: Feb 1, 1981

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