Minocycline-induced retinal pigment epithelium hyperpigmentation masquerading as age-related macular degeneration: Case presentation and proposed mechanism
Purpose: We describe the case of an 80-year-old man with bilateral minocycline-induced retinal pigment epithelium (RPE) hyperpigmentation, which initially masqueraded as AMD. Secondarily, using multimodal imaging features, we propose a mechanism for the development of minocycline-induced RPE hyperpi...
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Elsevier
2024-12-01
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| Series: | American Journal of Ophthalmology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993624001646 |
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| author | Michael D. Yu Nikhil Bommakanti Yoshihiro Yonekawa Jose Serafin Pulido |
| author_facet | Michael D. Yu Nikhil Bommakanti Yoshihiro Yonekawa Jose Serafin Pulido |
| author_sort | Michael D. Yu |
| collection | DOAJ |
| description | Purpose: We describe the case of an 80-year-old man with bilateral minocycline-induced retinal pigment epithelium (RPE) hyperpigmentation, which initially masqueraded as AMD. Secondarily, using multimodal imaging features, we propose a mechanism for the development of minocycline-induced RPE hyperpigmentation. Observations: The patient was referred with concern for AMD given the presence of macular drusenoid deposits on optical coherence tomography. However, funduscopic evaluation showed dense granular parafoveal hyperpigmentation, with a diffuse slate-colored hyperpigmentation throughout the peripheral fundus. Short-wavelength fundus autofluorescence of the macula disclosed no irregularities (as would be expected with drusen) while on near-infrared reflectance (NIR) imaging, numerous hyperreflective foci were noted corresponding to the hyperpigmented granules observed clinically (as would instead be seen with melanin deposits). Clinical examination was notable for blue-gray hyperpigmentation of the lower and upper extremities, as well as of the face, periorbital skin, and sclera. Upon further questioning, the patient disclosed daily oral minocycline use for 15 years for acne rosacea, confirming a diagnosis of minocycline-induced hyperpigmentation of the RPE. Conclusions: Multimodal imaging can be useful for differentiating minocycline-induced RPE hyperpigmentation from similar masquerade entities. Timely diagnosis can prevent progressive vision loss. |
| format | Article |
| id | doaj-art-c2947b40945b45b191d0b0d1ac68e4d3 |
| institution | Kabale University |
| issn | 2451-9936 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj-art-c2947b40945b45b191d0b0d1ac68e4d32024-12-18T08:50:36ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362024-12-0136102154Minocycline-induced retinal pigment epithelium hyperpigmentation masquerading as age-related macular degeneration: Case presentation and proposed mechanismMichael D. Yu0Nikhil Bommakanti1Yoshihiro Yonekawa2Jose Serafin Pulido3From the Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, 19107, USAFrom the Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, 19107, USAFrom the Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, 19107, USACorresponding author. Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, 19107, USA.; From the Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, 19107, USAPurpose: We describe the case of an 80-year-old man with bilateral minocycline-induced retinal pigment epithelium (RPE) hyperpigmentation, which initially masqueraded as AMD. Secondarily, using multimodal imaging features, we propose a mechanism for the development of minocycline-induced RPE hyperpigmentation. Observations: The patient was referred with concern for AMD given the presence of macular drusenoid deposits on optical coherence tomography. However, funduscopic evaluation showed dense granular parafoveal hyperpigmentation, with a diffuse slate-colored hyperpigmentation throughout the peripheral fundus. Short-wavelength fundus autofluorescence of the macula disclosed no irregularities (as would be expected with drusen) while on near-infrared reflectance (NIR) imaging, numerous hyperreflective foci were noted corresponding to the hyperpigmented granules observed clinically (as would instead be seen with melanin deposits). Clinical examination was notable for blue-gray hyperpigmentation of the lower and upper extremities, as well as of the face, periorbital skin, and sclera. Upon further questioning, the patient disclosed daily oral minocycline use for 15 years for acne rosacea, confirming a diagnosis of minocycline-induced hyperpigmentation of the RPE. Conclusions: Multimodal imaging can be useful for differentiating minocycline-induced RPE hyperpigmentation from similar masquerade entities. Timely diagnosis can prevent progressive vision loss.http://www.sciencedirect.com/science/article/pii/S2451993624001646MinocyclineHyperpigmentationRetinaRetinal pigment epitheliumOptical coherence tomographyFundus autofluorescence |
| spellingShingle | Michael D. Yu Nikhil Bommakanti Yoshihiro Yonekawa Jose Serafin Pulido Minocycline-induced retinal pigment epithelium hyperpigmentation masquerading as age-related macular degeneration: Case presentation and proposed mechanism American Journal of Ophthalmology Case Reports Minocycline Hyperpigmentation Retina Retinal pigment epithelium Optical coherence tomography Fundus autofluorescence |
| title | Minocycline-induced retinal pigment epithelium hyperpigmentation masquerading as age-related macular degeneration: Case presentation and proposed mechanism |
| title_full | Minocycline-induced retinal pigment epithelium hyperpigmentation masquerading as age-related macular degeneration: Case presentation and proposed mechanism |
| title_fullStr | Minocycline-induced retinal pigment epithelium hyperpigmentation masquerading as age-related macular degeneration: Case presentation and proposed mechanism |
| title_full_unstemmed | Minocycline-induced retinal pigment epithelium hyperpigmentation masquerading as age-related macular degeneration: Case presentation and proposed mechanism |
| title_short | Minocycline-induced retinal pigment epithelium hyperpigmentation masquerading as age-related macular degeneration: Case presentation and proposed mechanism |
| title_sort | minocycline induced retinal pigment epithelium hyperpigmentation masquerading as age related macular degeneration case presentation and proposed mechanism |
| topic | Minocycline Hyperpigmentation Retina Retinal pigment epithelium Optical coherence tomography Fundus autofluorescence |
| url | http://www.sciencedirect.com/science/article/pii/S2451993624001646 |
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