In vivo confocal microstructural analysis of corneal endothelial changes in a patient on long-term chlorpromazine therapy

Graefes Arch Clin Exp Ophthalmol. 2005 Jul;243(7):721-3. doi: 10.1007/s00417-004-0982-z. Epub 2005 Mar 3.

Abstract

Background: Deposits in the cornea and lens are a known complication of long-term chlorpromazine therapy.

Method: A 59-year-old woman had previously taken chlorpromazine for 20 years with doses up to 1,200 mg/day, with a mean dose of 400 mg/day. She presented with gradual onset of blurred vision in her left eye. Slit-lamp biomicroscopy revealed multiple fine creamy-white deposits on her corneal endothelium and anterior crystalline lens capsule bilaterally.

Results: In vivo confocal microscopy of the cornea identified irregular hyper-reflective deposits on the posterior surface of the endothelium. The deposits varied from 1 microm to 70 microm in diameter and had well-defined edges. Endothelial morphology was otherwise normal bilaterally.

Conclusions: This is the first report of in vivo confocal imaging of deposits resulting from long-term chlorpromazine use. Microstructural analysis of the corneal endothelium reveals that there were no abnormalities in cellular morphology resulting from these deposits.

Publication types

  • Case Reports

MeSH terms

  • Chlorpromazine / adverse effects*
  • Corneal Diseases / chemically induced*
  • Corneal Diseases / diagnosis
  • Dopamine Antagonists / adverse effects*
  • Endothelium, Corneal / drug effects*
  • Endothelium, Corneal / pathology*
  • Female
  • Humans
  • Microscopy, Confocal
  • Middle Aged

Substances

  • Dopamine Antagonists
  • Chlorpromazine