In vivo confocal microstructural analysis of corneal endothelial changes in a patient on long-term chlorpromazine therapy.
BACKGROUND
Deposits in the cornea and lens are a known complication of long-term chlorpromazine therapy.


METHODS
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.
Phua
Yun Shan
YS
Department of Ophthalmology, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019 Auckland, New Zealand.
Patel
Dipika V
DV
McGhee
Charles N J
CN
D002746:Chlorpromazine / Q000009:adverse effects*; D003316:Corneal Diseases / Q000139:chemically induced* / Q000175:diagnosis; D018492:Dopamine Antagonists / Q000009:adverse effects*; D004728:Endothelium, Corneal / Q000187:drug effects* / Q000473:pathology*; D005260:Female; D006801:Humans; D018613:Microscopy, Confocal; D008875:Middle Aged
D018492:Dopamine Antagonists; D002746:Chlorpromazine
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