Didanosine-induced Retinopathy: New Insights with Long-term Follow-up

Faure, Céline; Chassery, Maxime; Orès, Raphaëlle; Audo, Isabelle

doi:10.1080/09273948.2021.1927117

Cited by 4 publications

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“…Other NRTI, such as zidovudine, entecavir, lamivudine, and a protease inhibitor, ritonavir, have been linked to retinopathy. To address this concern, continuous retinal screening of patients taking the new generation of NRTI can be proposed [22].…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Didanosine-Induced Mid-Peripheral Chorioretinal Atrophy Identified Incidentally 11 Years after the Drug Cessation

et al. 2022

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Objective: This article aims to describe a unique case of didanosine-induced retinal degeneration that was discovered 11 years after the drug withdrawal. Case report: The patient is a 42-year-old woman with a medical history of HIV and hepatitis C virus since 2004. She has been prescribed antiretroviral therapy since then. For the first seven years (2004–2011), the patient was prescribed a combination therapy consisting of didanosine, efavirenz, and lamivudine. The protocol was changed to atripla (efavirenz, emtricitabine, and tenofovir) from 2011 to 2021. Recently (October 2021–January 2021), the patient was prescribed eviplera (rilpivirin, emtricitabine, and tenofovir). In addition, her past medical history revealed Gougerot-Sjogren syndrome and rheumatoid arthritis. She was prescribed hydroxychloroquine (HCQ) (2009–2021) at a dose of 400 mg daily. She had no vision complaint. Results: During her routine HCQ screening at the eye clinic, University Hospital Bretonneau, Tours, France, the widefield colour fundus photograph showed well-defined symmetric mid-peripheral areas of chorioretinal atrophy sparing the posterior pole of both eyes. Furthermore, the widefield fundus autofluorescence illustrated mid-peripheral round well-demarcation hypoautofluorescent areas of chorioretinal atrophy of both eyes. Conversely, the macular optical coherence tomography (OCT) was normal. Many of her drugs are known to be associated with retinopathy such as HCQ, tenofovir, efavirenz, and didanosine. Because our data corroborate peripheral retinal damage rather than posterior pole damage, this case report is compatible with didanosine-induced retinopathy rather than HCQ, efavirenz, or tenofovir retinal toxicity. Conclusions: All HIV patients who are presently or were previously on didanosine therapy should have their fundus examined utilising widefield fundus autofluorescence and photography.

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Section: Discussionmentioning

confidence: 99%

A Rare Case of Didanosine-Induced Mid-Peripheral Chorioretinal Atrophy Identified Incidentally 11 Years after the Drug Cessation

et al. 2022

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“…[12] Ayrıca olguların çoğunluğunda tam alan ERG' de generalize rod-kon disfonksiyonunun uzun süre stabil kaldığı belirtilmiştir. [11] Didanozine bağlı yamalı midperifer yerleşimli koryoretinal atrofi alanlarının serum ornitin seviyelerinin normal olması ile Gyrate atrofiden ve kliniğinin yavaş seyirli olması ile progresif dış retinal nekrozdan ayrımı yapılabilir. Didanozin toksisitesi, mitokondriyal bozukluklara eşlik eden retinopatilere fenotipik olarak çok benzer fundoskopik ve FOF özelliklerine (konsantrik koryoretinal atrofi) sahiptir.…”

Section: Dideoksinozinunclassified

Medications Damaging Retinal Pigment Epithelium and Photoreceptor Complex-4: Pathogenesis, Diagnosis, and Treatment (Dideoxynosine, MEK Inhibitors, Sildenafil, Corticosteroids, Poppers/Alkyl Nitrate, Cisplatin, Carmustine)

2023

Güncel Retina (Current Retina)

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Systemic, topical, and intravitreal medications could induce retinal toxicity. Disruption of the retina and retinal pigment epithelium, vascular damage, cystoid macular edema, retinal folds, crystalline retinopathy, uveitis, and miscellaneous are patterns of retinal toxicity. Medications that could generate permanent impairment, and damage RPE and photoreceptor cells are significant. This article outlines pathogenesis, current diagnosis, and treatments of widely used dideoxyinosine, MEK inhibitors, sildenafil, corticosteroids, poppers/alkyl nitrate, cisplatin, and carmustine causing RPE and photoreceptor cells damage.

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Antiretrovirals

2023

Reactions Weekly

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Didanosine-induced Retinopathy: New Insights with Long-term Follow-up

Cited by 4 publications

References 29 publications

A Rare Case of Didanosine-Induced Mid-Peripheral Chorioretinal Atrophy Identified Incidentally 11 Years after the Drug Cessation

A Rare Case of Didanosine-Induced Mid-Peripheral Chorioretinal Atrophy Identified Incidentally 11 Years after the Drug Cessation

Medications Damaging Retinal Pigment Epithelium and Photoreceptor Complex-4: Pathogenesis, Diagnosis, and Treatment (Dideoxynosine, MEK Inhibitors, Sildenafil, Corticosteroids, Poppers/Alkyl Nitrate, Cisplatin, Carmustine)

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