title: An experimental treatment of ocular quinine toxicity with high-dose 9-cis Beta-carotene.
abstract: OBJECTIVE
  To report a case of severe ocular quinine toxicity after a suicide attempt and an experimental treatment with high-dose 9-cis beta-carotene.
  
  
  METHODS
  Interventional case report.
  
  
  RESULTS
  A 59-year-old woman presented with acute bilateral blindness after ingesting high dose (12 g) of quinine sulphate. Her vision was no light perception in either eye, and her pupils were fixed and middilated. Because of limited vision and poor prognosis, she was treated with an experimental rescue therapy of high-dose 9-cis beta-carotene Dunaliella bardawil powder for 3 months, starting 10 days postingestion. Electroretinography measurements showed transient improvement in a-wave amplitudes. The electroretinography b-wave showed only partial transient improvement in the left eye. Overall, the patient's visual acuity improved to 20/33 in the right eye and 20/40 in the left eye, but with extremely constricted visual fields.
  
  
  CONCLUSIONS
  Transient improvement in electroretinography measurements was observed under treatment with high-dose 9-cis beta-carotene in ocular quinine toxicity, although no clinical benefit was documented. More research is needed to determine its effect in patients with toxic retinal damage.
authors.affiliation: *Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel; and †Department of Ophthalmology, Sheba Medical Center, Tel HaShomer, Israel.
authors.forename: Amit
authors.initials: A
authors.lastname: Meshi
authors.forename: Avner
authors.initials: A
authors.lastname: Belkin
authors.forename: Tal
authors.initials: T
authors.lastname: Koval
authors.forename: Tom
authors.initials: T
authors.lastname: Kornhouser
authors.forename: Ehud I
authors.initials: EI
authors.lastname: Assia
authors.forename: Ygal
authors.initials: Y
authors.lastname: Rotenstreich
mesh_terms: D000284:Administration, Oral; D018712:Analgesics, Non-Narcotic / Q000506:poisoning; D001766:Blindness / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D008875:Middle Aged; D011803:Quinine / Q000506:poisoning*; D012160:Retina / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D013406:Suicide, Attempted; D014792:Visual Acuity; D014794:Visual Fields; D014815:Vitamins / Q000008:administration & dosage / Q000627:therapeutic use; D019207:beta Carotene / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D018712:Analgesics, Non-Narcotic; D014815:Vitamins; D019207:beta Carotene; D011803:Quinine