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Ophthalmology · Retina: thioridazine retinopathy
Sample itemA psychotic patient on a high dose of an antipsychotic reports poor night vision and brownish discolouration of vision. The fundus shows coarse pigment clumping and mottling of the posterior pole. Which drug is the likely cause?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Thioridazine
Thioridazine, a phenothiazine, causes dose-related pigmentary retinopathy by damaging the retinal pigment epithelium. The risk is why its dose is limited. Other antipsychotics are not typical causes of such retinopathy.
Option by option
A. Haloperidol
Haloperidol is not a typical cause of pigmentary retinopathy.
B. Olanzapine
Olanzapine does not cause pigmentary retinopathy.
C. Clozapine
Clozapine is not associated with pigmentary retinal toxicity.
D. Thioridazine (correct)
Correct. Thioridazine produces pigmentary retinopathy at high dose.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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