Ritonavir and bull's eye maculopathy: case report.
OBJECTIVE
To report on a case of retinal pigment epithelium (RPE) toxicity apparently associated with ritonavir.


METHODS
We describe a case of gradual-onset blurry vision in both eyes in a 30-year-old HIV-positive male on Highly-Active Antiretroviral Therapy (HAART) including ritonavir Results: The patient presented with a visual acuity of 3/10 in each eye, and fundoscopy revealed paracentral pigment mottling. Computerized perimetry showed a ring-scotoma in both eyes. Fluorescein angiography revealed an anular RPE defect in both eyes, congruent with hyperautofluorescent changes on autofluorescence imaging. Full-field ERG was normal.


CONCLUSIONS
Since ritonavir has previously been linked with toxicity to the RPE, we consider this report as further evidence of this association.
Instituto de Oftalmologia Dr Gama Pinto, Lisboa, Portugal.
Rita
R
Pinto
Instituto de Oftalmologia Dr Gama Pinto, Lisboa, Portugal.
Marta
M
Vila-Franca
Departamento de Infecciologia do Hospital de Santa Maria, Lisboa, Portugal.
Cláudia
C
Oliveira Afonso
Instituto de Oftalmologia Dr Gama Pinto, Lisboa, Portugal.
Conceição
C
Ornelas
Instituto de Oftalmologia Dr Gama Pinto, Lisboa, Portugal.
Luisa
L
Santos
AIDS; retinal pigment epithelium; retinal toxicity; ritonavir