title: Functional and Structural Abnormalities in Deferoxamine Retinopathy: A Review of the Literature.
abstract: Deferoxamine mesylate (DFO) is the most commonly used iron-chelating agent to treat transfusion-related hemosiderosis. Despite the clear advantages for the use of DFO, numerous DFO-related systemic toxicities have been reported in the literature, as well as sight-threatening ocular toxicity involving the retinal pigment epithelium (RPE). The damage to the RPE can lead to visual field defects, color-vision defects, abnormal electrophysiological tests, and permanent visual deterioration. The purpose of this review is to provide an updated summary of the ocular findings, including both functional and structural abnormalities, in DFO-treated patients. In particular, we pay particular attention to analyzing results of multimodal technologies for retinal imaging, which help ophthalmologists in the early diagnosis and correct management of DFO retinopathy. Fundus autofluorescence, for example, is not only useful for screening patients at high-risk of DFO retinopathy, but is also a prerequisite for identify specific high-risk patterns of RPE changes that are relevant for the prognosis of the disease. In addition, optical coherence tomography may have a clinical usefulness in detecting extent and location of different retinal changes in DFO retinopathy. Finally, this review wants to underline the need for universally approved guidelines for screening and followup of this particular disease.
authors.affiliation: Ophthalmological Unit, Department of Clinical Sciences and Community Health, Ca' Granda Foundation-Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza 35, 20122 Milan, Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Di Nicola
authors.affiliation: Ophthalmological Unit, Department of Clinical Sciences and Community Health, Ca' Granda Foundation-Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza 35, 20122 Milan, Italy ; Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA.
authors.forename: Giulio
authors.initials: G
authors.lastname: Barteselli
authors.affiliation: Ophthalmological Unit, Department of Clinical Sciences and Community Health, Ca' Granda Foundation-Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza 35, 20122 Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Dell'Arti
authors.affiliation: Ophthalmological Unit, Department of Clinical Sciences and Community Health, Ca' Granda Foundation-Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza 35, 20122 Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Ratiglia
authors.affiliation: Ophthalmological Unit, Department of Clinical Sciences and Community Health, Ca' Granda Foundation-Ospedale Maggiore Policlinico, University of Milan, Via Francesco Sforza 35, 20122 Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Viola
mesh_terms: D003676:Deferoxamine / Q000009:adverse effects* / Q000627:therapeutic use; D006486:Hemosiderosis / Q000188:drug therapy; D006801:Humans; D007502:Iron Chelating Agents / Q000009:adverse effects* / Q000627:therapeutic use; D012160:Retina / Q000187:drug effects / Q000473:pathology; D012164:Retinal Diseases / Q000139:chemically induced* / Q000473:pathology / Q000517:prevention & control / Q000628:therapy; D012171:Retinal Vessels / Q000187:drug effects / Q000473:pathology
chemical_list: D007502:Iron Chelating Agents; D003676:Deferoxamine