perhexiline-maleate and Papilledema

Topics: Anti-Bacterial Agents; Antineoplastic Agents; Antitubercular Agents; Central Nervous System Agents; Clioquinol; Humans; Optic Atrophy; Optic Nerve Diseases; Optic Neuritis; Papilledema; Perhexiline

We report a case of perhexilene maleate (PEXID) toxicity in which the presenting feature was loss of vision secondary to chronic papilloedema. Vortex keratopathy similar to that seen in amiodarone keratopathy was present, and corneal and conjunctival biopsy findings are presented. To our knowledge this is the first case report of a keratopathy occurring in perhexilene toxicity. After withdrawal of the drug the papilloedema and keratopathy subsided, but some visual deficit remains. The properties of perhexilene maleate and other amphiphilic drugs are described, and the possible aetiology of vortex keratopathy is discussed.

Topics: Conjunctiva; Epithelium; Fluorescein Angiography; Humans; Male; Microscopy, Electron; Middle Aged; Papilledema; Perhexiline; Vision Disorders

Perhexiline maleate is an agent currently under investigation in Canada that is used for angina unresponsive to other treatment. This paper describes a possible side effect previously unreported--papilledema not associated with peripheral neuropathy.

Topics: Adult; Angina Pectoris; Fluorescein Angiography; Humans; Male; Papilledema; Perhexiline; Piperidines; Visual Fields