Limits...
Methotrimeprazine-induced corneal deposits and cataract revealed by urine drug profiling test.

Kim ST, Koh JW, Kim JM, Kim WY, Choi GJ - J. Korean Med. Sci. (2010)

Bottom Line: We performed a drug profiling test using urine samples and detected methotrimeprazine.Visual acuity improved in both eyes, but the corneal deposits remained.We report an unusual case of methotrimeprazine-induced corneal deposits and cataract in a patient with psychosis, identified by using the urine drug profiling test.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Korea.

ABSTRACT
Two schizophrenic patients who had been taking medication for a long period presented with visual disturbance of 6-month duration. Slit-lamp examination revealed fine, discrete, and brownish deposits on the posterior cornea. In addition, bilateral star-shaped anterior subcapsular lens opacities, which were dense, dust-like granular deposits, were noted. Although we strongly suspected that the patient might have taken one of the drugs of the phenothiazine family, we were unable to obtain a history of medications other than haloperidol and risperidone, which were taken for 3 yr. We performed a drug profiling test using urine samples and detected methotrimeprazine. The patient underwent surgery for anterior subcapsular lens opacities. Visual acuity improved in both eyes, but the corneal deposits remained. We report an unusual case of methotrimeprazine-induced corneal deposits and cataract in a patient with psychosis, identified by using the urine drug profiling test.

Show MeSH

Related in: MedlinePlus

Slit lamp photographs (Case 2). It showed fine, discrete, and brownish deposits on the posterior cornea. (A) right eye, (B) left eye. It showed characteristic star-shaped deposits in the anterior sub-capsular area. (C) right eye, (D) left eye.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2967013&req=5

Figure 2: Slit lamp photographs (Case 2). It showed fine, discrete, and brownish deposits on the posterior cornea. (A) right eye, (B) left eye. It showed characteristic star-shaped deposits in the anterior sub-capsular area. (C) right eye, (D) left eye.

Mentions: In another case, a 28-yr-old woman, also being treated for mental retardation, hysteria, and nervous ticks, had been experiencing visual disturbance for over a period of 4 months (Jan 12, 2009). Previously, she had been hospitalized and received outpatient care for these psychiatric illnesses for 4 yr. Slit-lamp examination revealed fine, discrete, and brownish deposits on the posterior cornea (Fig. 2A, B). In addition, bilateral star-shaped anterior subcapsular lens opacities, which were dense, dust-like granular deposits, were noted (Fig. 2C, D). Visual acuity was 20/50 in both eyes. Other ocular findings were normal. The patient was treated with 9 mg of haloperidol (thioxanthene family), 300 mg of valproic acid, 1 mg of benztropine, 50 mg of trazodone, and 2.5 mg of diazepam. After diazepam was discontinued, she was given 15 mg of haloperidol, 400 mg of valproic acid, 1 mg of benztropine, and 1 mg of risperidone (molindone family), accordingly. At that time, we strongly suspected that the patient was taking a drug from the phenothiazine family, but we could not find any evidence of such use. However, we did detect methotrimeprazine in her body by using the Remedi HS drug profiling system (Bio-Rad Co., Hercules, CA, USA). Analyzing the medical history, we discovered that the patient habitually took methotrimeprazine over a period of 4 yr by obtaining prescriptions from various doctors, on suffering from any anxiety or discomfort. Furthermore, on the basis of clinical and laboratory results, methotrimeprazine-induced corneal deposits and cataract were detected.


Methotrimeprazine-induced corneal deposits and cataract revealed by urine drug profiling test.

Kim ST, Koh JW, Kim JM, Kim WY, Choi GJ - J. Korean Med. Sci. (2010)

Slit lamp photographs (Case 2). It showed fine, discrete, and brownish deposits on the posterior cornea. (A) right eye, (B) left eye. It showed characteristic star-shaped deposits in the anterior sub-capsular area. (C) right eye, (D) left eye.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2967013&req=5

Figure 2: Slit lamp photographs (Case 2). It showed fine, discrete, and brownish deposits on the posterior cornea. (A) right eye, (B) left eye. It showed characteristic star-shaped deposits in the anterior sub-capsular area. (C) right eye, (D) left eye.
Mentions: In another case, a 28-yr-old woman, also being treated for mental retardation, hysteria, and nervous ticks, had been experiencing visual disturbance for over a period of 4 months (Jan 12, 2009). Previously, she had been hospitalized and received outpatient care for these psychiatric illnesses for 4 yr. Slit-lamp examination revealed fine, discrete, and brownish deposits on the posterior cornea (Fig. 2A, B). In addition, bilateral star-shaped anterior subcapsular lens opacities, which were dense, dust-like granular deposits, were noted (Fig. 2C, D). Visual acuity was 20/50 in both eyes. Other ocular findings were normal. The patient was treated with 9 mg of haloperidol (thioxanthene family), 300 mg of valproic acid, 1 mg of benztropine, 50 mg of trazodone, and 2.5 mg of diazepam. After diazepam was discontinued, she was given 15 mg of haloperidol, 400 mg of valproic acid, 1 mg of benztropine, and 1 mg of risperidone (molindone family), accordingly. At that time, we strongly suspected that the patient was taking a drug from the phenothiazine family, but we could not find any evidence of such use. However, we did detect methotrimeprazine in her body by using the Remedi HS drug profiling system (Bio-Rad Co., Hercules, CA, USA). Analyzing the medical history, we discovered that the patient habitually took methotrimeprazine over a period of 4 yr by obtaining prescriptions from various doctors, on suffering from any anxiety or discomfort. Furthermore, on the basis of clinical and laboratory results, methotrimeprazine-induced corneal deposits and cataract were detected.

Bottom Line: We performed a drug profiling test using urine samples and detected methotrimeprazine.Visual acuity improved in both eyes, but the corneal deposits remained.We report an unusual case of methotrimeprazine-induced corneal deposits and cataract in a patient with psychosis, identified by using the urine drug profiling test.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Korea.

ABSTRACT
Two schizophrenic patients who had been taking medication for a long period presented with visual disturbance of 6-month duration. Slit-lamp examination revealed fine, discrete, and brownish deposits on the posterior cornea. In addition, bilateral star-shaped anterior subcapsular lens opacities, which were dense, dust-like granular deposits, were noted. Although we strongly suspected that the patient might have taken one of the drugs of the phenothiazine family, we were unable to obtain a history of medications other than haloperidol and risperidone, which were taken for 3 yr. We performed a drug profiling test using urine samples and detected methotrimeprazine. The patient underwent surgery for anterior subcapsular lens opacities. Visual acuity improved in both eyes, but the corneal deposits remained. We report an unusual case of methotrimeprazine-induced corneal deposits and cataract in a patient with psychosis, identified by using the urine drug profiling test.

Show MeSH
Related in: MedlinePlus