Title

ORGANOPHOSPHATE RETINOPATHY: CASE REPORT

Introduction

There are rare reports of retinal degeneration caused by organophosphates intoxication. Due to the small amount of reports, the findings are few described and documented. Our intention is to describe and document the findings observed in a patient who suffered severe visual loss after organophosphate poisoning.

Methods

Case description, retinography, autofluorescence retinography and OCT images.

Results

A 34-year-old female patient was referred by the ophthalmology service to investigate retinal dystrophy. He has significant visual loss in both eyes and strongly states that the episode of visual loss happened shortly after the onset of organophosphate poisoning 22 years ago. She reports that during her childhood, she always had good eyesight. Denies comorbidities. The ophthalmological examination showed visual acuity with better correction of hand movement in both eyes, IOP 14 and biomicroscopy without significant changes. At fundscopy, reveals a pale optic nerve, vessels attenuation, mottled and pale macula extending to peripapilar region with bone spicule pigmentation, similar to retinitis pigmentosa. Autofluorescence presents an area of ​​macular and peripapillary hypoautofluorescence with discrete hypererautofluorescence borders and optical coherence tomography shows bilateral macular thinning and disruption of the photoreceptor-retinal pigmented epithelium complex .

Discussion

In 1985, Misra et al. described retinal findings linked to acute and prolonged exposure to organophosphates. The main findings in these patients were macular changes, present in 19% of these, which included changes in perifoveal pigmentation and areas of hypopigmentation of small / medium size. Exposure to organophosphates can lead to significant visual impairment, resulting in decreased quality of life. Our case illustrates the importance of exploring a history of exposure to organophosphates in the differential diagnosis of what could be considered a retinal dystrophy.

Keywords

organophosphpates, retina, dystrophy

Area

CLINICAL CASE

Authors

PEDRO JAVIER YUGAR, THIAGO CARVALHO BARROS DE OLIVEIRA, ANDRE JUCA MACHADO, ALLAN VICTOR DOS SANTOS GONÇALVES, BARBARA DE ARAUJO LIMA DUTRA, FRANCYELLE SAMYRAMIS LOURENÇO, ANYSSA BRILHANTE AIRES MONTENEGRO, CAROLINA LYRA BARREIRA CARNEIRO