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Hedayat Javidi, Konstantinos Balaskas, Tariq Aslam, Sajjad Mahmood; Adverse ocular effect of sertraline use: case series of sertraline-associated maculopathy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1206.
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To report on two cases of possible sertraline related maculopathy, one shortly after treatment commenced and one after long term usage. Sertraline, a selective serotonin re-uptake inhibitor (SSRI), is one of the most prescribed antidepressants in the United States. Its use for the management of depression, anxiety, eating disorders and premenstrual dysphonic disorder has become a mainstay of treatment. Only a small number of cases of maculopathy associated with sertraline use have previously been reported.
Report ocular examination findings, features on spectral domain OCT scanning and review of available literature.
The first case describes that of a 27 year old female presenting with a 2 week history of paracentral scotoma just above the fixation point. This patient had commenced sertraline 4 weeks prior to her symptoms for treatment of panic attacks but otherwise had no significant past medical history. Her visual acuity was reduced to 6/9.5 bilaterally and Optical Coherence Tomography (OCT) showed disruption of the photoreceptor layer just below the centre of the fovea. Symptoms resolved on discontinuation of sertraline. The second case describes a 36 year old female presenting with a generalised deterioration in vision and who had become acutely symptomatic approximately 3 months before presentation. Past medical history included anxiety, depression, mood swings and chronic back pain. She had been taking sertraline for 5 years prior to the onset of symptoms. Visual acuity was 6/36 bilaterally and this did not improve 1 year after discontinuation of sertraline. OCT scan demonstrated similar architectural disturbance in the outer retina to the first case.
Given the prevalence of sertraline use, it is important for physicians to be aware of the possibility of effects on vision and macular adverse effects. With only a small number of reported cases, we advocate a wider awareness of this condition.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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