Deferoxamine: Pigmentary Retinopathy
This retina shows the speckled pigmentation and narrowed arterioles typical of damage to the retinal pigment epithelium and photoreceptors.
The patient, who has been treated with deferoxamine mesylate, an iron chelator used in hemochromatosis, complains of blurred vision, poor night vision, poor color vision, or peripheral visual field loss. These symptoms typically precede ophthalmoscopic signs by weeks to months. Once signs have appeared, visual dysfunction is largely irreversible.
Retinal toxicity may develop acutely or after chronic administration. Therefore, patients should have a baseline ophthalmological examination before starting on this medication and be advised to report any visual symptoms immediately. They should be routinely rescreened every three months while on treatment.