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Shawn Iverson, John Payne; Bull’s Eye Maculopathy Secondary to Pitavastatin (Livalo). Invest. Ophthalmol. Vis. Sci. 2016;57(12):5391.
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© ARVO (1962-2015); The Authors (2016-present)
To report the clinical features and diagnostic imaging characteristics of pitavastatin-associated toxic maculopathy. Pitavastatin is a unique member of the statin family that contains a quinoline ring, which is a chemical structure also found in hydroxychloroquine and chloroquine.
Case report and literature review
A 74 year-old retired dermatologist presented with six months of bilateral central vision changes described as a scintillating scotoma. Symptoms began approximately 12 months after starting pitavastatin, a member of the statin family designed to improve LDL-cholesterol levels. Best corrected visual acuity was 20/25 in both eyes and fundoscopic examination revealed bilateral pigmentary changes of the retinal pigment epithelium consistent with an early bull’s eye. Spectral-domain optical coherence tomography demonstrated a loss of the ellipsoid zone in the parafoveal region. Fluorescein angiography showed a parafoveal ring of hyperfluorescence in each eye, which corresponded with an area of stippled hypoautofluorescence seen on autofluorescence imaging. Microperimetric testing showed a dense annular scotoma with a preserved central island of vision in both eyes. His visual acuity and clinical examination features did not change 20 months after drug cessation.
Pitavastatin, a unique member of the statin family which contains a quinoline ring, can lead to clinical features similar to hydroxychloroquine or chloroquine maculopathy. This is the first report of pitavastatin-associated toxic maculopathy.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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