Systemic medications reach the cornea through the tear film, aqueous humor and limbal vasculature. Acute onset of halos and glare: Bilateral corneal epithelail edema with cystic eruptions-atypical presentation of amiodarone keratopathy. Access from the tear film leads to deposition in the epithelium, from the limbal vasculature into the stroma, and from the aqueous into the endothelium, epithelium and stroma. Does plaquenil cause low white blood cell count Risk of plaquenil retinopathy Chloroquine dosing for lupus Chloroquine CQ is used to prevent and treat malaria and amebiasis,1 while hydroxychloroquine HCQ, a less toxic metabolite of chloroquine, is used to treat rheumatic diseases such as systemic lupus erythematosus SLE, rheumatoid arthritis RA, juvenile idiopathic arthritis JIA and Sjogren's syndrome.2 Both medications can cause corneal deposits, posterior subcapsular lens opacity. Cornea verticillata, also called vortex keratopathy or whorl keratopathy, is a condition characterised by corneal deposits at the level of the basal epithelium forming a faint golden-brown whorl pattern. It is seen in Fabry disease or in case of prolonged amiodarone intake. Causes. Amiodarone Fabry’s disease Chloroquine Hydroxychloroquine Indomethacin. While corneal findings had been thought to have no correlation with the development of retinal toxicity, Aljoscha Neubauer, MD, and colleagues conducted a screening of 93 patients with marked corneal deposits who were taking either chloroquine or hydroxychloroquine, and using electro-oculogram and computerized color vision testing, found a 50%. It is, however, important to recognize these associations and to openly communicate your concerns with the primary care physician or specialist who prescribed the systemic drug, as they can be a precursor to lens, optic nerve or retinal changes that can cause permanent and serious vision impairment. Visual function and adverse ocular effects in patients with amiodarone medication. Fortunately, these corneal abnormalities usually are not visually debilitating or permanent. Cornea verticillata chloroquine Chloroquine keratopathy as an example of drug-induced., Cornea verticillata - Wikipedia Side effects of stopping hydroxychloroquinePlaquenil toxicity eye exam Corneal changes similar to those described in patients taking tamoxifen have also been reported in asymptomatic carriers of Fabry disease Anderson-Fabry disease. Cornea verticillata, a whorl-like opacity, has become one of the hallmarks of Fabry disease. 6 A Case of Tamoxifen Keratopathy Cornea JAMA Ophthalmology.. When ‘Collateral Damage’ Strikes the Cornea. Does Patient with Lupus Have Plaquenil Retinopathy?. A 77-year-old man was referred to the cornea service for bilateral corneal verticillata noted first by his general ophthalmologist. One year prior to presentation, the patient had undergone coronary artery bypass grafting CABG. He was discharged with amiodarone and used the medication for 6 weeks. Disease Entity Cornea verticillata also called vortex keratopathy, whorl keratopathy, or Fleischer vortex describes a whorl-like pattern of golden brown or gray opacities in the cornea. Corneal verticillata. Like a number of other drugs, HCQ and CQ can cause corneal verticillata also known as vortex keratopathy. These epithelial changes arise due to precipitation of the drug, typically forming a whorl-like pattern that is reversible with drug cessation.