Ritonavir associated maculopathy– multimodal imaging and electrophysiology findings

Purpose: To report the case 47-year-old patient presenting with severe maculopathy associated with long-term ritonavir treatment. Methods: Observational case report of one patient and literature review. Results: A 47 year-old Caucasian man presented with progressive bilateral vision loss for the pas...

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Bibliographic Details
Main Authors: Roxane Bunod, Alexandra Miere, Olivia Zambrowski, Pierre-Marie Girard, Laure Surgers, Eric H. Souied
Format: Article
Language:English
Published: Elsevier 2020-09-01
Series:American Journal of Ophthalmology Case Reports
Subjects:
HIV
Online Access:http://www.sciencedirect.com/science/article/pii/S2451993619300957
Description
Summary:Purpose: To report the case 47-year-old patient presenting with severe maculopathy associated with long-term ritonavir treatment. Methods: Observational case report of one patient and literature review. Results: A 47 year-old Caucasian man presented with progressive bilateral vision loss for the past 5 years. His medical history included Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) coinfection since 1992. He was treated by highly active antiretroviral therapy for 24 years including 4 years of didanosine treatment and 18 years of ritonavir treatment. Bilateral extensive macular atrophy with foveal sparing on the left eye and absence of midperipheral/peripheral retina involvement was confirmed on multimodal imaging and functional testing including swept-source OCT angiography and electroretinography. Conclusion: Ritonavir associated maculopathy is a scarcely described medication-associated retinopathy. In this case, an extensive macular atrophy (with complete loss of photoreceptor, RPE and choriocapillaris layers) and subsequent cone-rod dysfunction appeared after 18 years of ritonavir exposure.
ISSN:2451-9936