FP310

BE BOLD AND BEHOLD –Reversed acute idiopathic maculopathy due to presumed digoxin retinal toxicity

A 62-year-old gentleman presented with diminution of vision in both eyes for 5 days. He was a known case of diabetes, hypertension, mild cardiac failure and hyperlipidemia on a wide range of systemic medications. Anterior segment examination was normal. Right eye fundus examination showed faint yellow discoloration in macular area and left eye fundus was normal.
Optical coherence tomography showed focal disruption of ellipsoid zone in both eyes alongwith ellipsoid zone thickening. Possibility of drug insult to photoreceptors was considered based on outer retinal layer appearance. Fundus fluorescein angiography did not show any leakage. After consultation with cardiologist digoxin was stopped. On follow up, OCT showed near complete resolution of ellipsoid zone thickening with improvement in visual acuity.
Conclusion: This case highlights the need of well monitored use of digoxin along with role of OCT in detection of novel feature of reversible ellipsoid zone thickening.