[Serous macular detachment of the neuro-epithelium and flumequine]. 1983

D Sirbat, and E Saudax, and B Hurault de Ligny, and E Hachet, and A Raspiller

Flumequine (1 200 mg/day) was prescribed as treatment for infection of the urinary tract to three patients with chronic renal failure, who reported positive scotoma three days later. Ophthalmologic examination evinced bilateral symmetrical macular bullae. A characteristic yellow papule was present at foveal level. In all three cases, visual acuity was impaired (down to 4/10), without any angiographic alteration. Foveolas showed a moderate persistent hyperfluorescence. All patients recovered a normal visual acuity, within two days after treatment cessation, and bullae disappeared without sequelae within 5 days. The chronology and kinetics of clinical manifestations were clearly and reproducibly correlated with flumequine therapy in all patients, and suggest that this drug may be considered responsible for the ocular symptom reported. Chronic renal failure (creatinine clearance lower than 25 ml/mn) most certainly favoured the appearance of visual troubles, but other factors may possibly play a similar role: hepatic failure, individual hypersensitivity... Quinolones used as urinary antiseptics (nalidixic acid, oxolinic acid, pipemidic acid...), and other flumequine analogues may possibly be involved in such side-effects. This was reported by Bouissou et al. in an experimental model with nalidixic acid, where transient bullae appeared on young animals' articular cartilage. Such lesions are related to focal alterations of the C2 intermediary layer of cartilage, with marked edema of the interstitial material. The volume of synovial fluid increases concomitantly. These alterations suggest a direct cytotoxic effect at the intercellular level of target organs, a mechanism possibly also occurring in the retina.

UI MeSH Term Description Entries
D007676 Kidney Failure, Chronic The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION. ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D008266 Macula Lutea An oval area in the retina, 3 to 5 mm in diameter, usually located temporal to the posterior pole of the eye and slightly below the level of the optic disk. It is characterized by the presence of a yellow pigment diffusely permeating the inner layers, contains the fovea centralis in its center, and provides the best phototropic visual acuity. It is devoid of retinal blood vessels, except in its periphery, and receives nourishment from the choriocapillaris of the choroid. (From Cline et al., Dictionary of Visual Science, 4th ed) Lutea, Macula,Luteas, Macula,Macula Luteas
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011807 Quinolizines
D012163 Retinal Detachment Separation of the inner layers of the retina (neural retina) from the pigment epithelium. Retinal detachment occurs more commonly in men than in women, in eyes with degenerative myopia, in aging and in aphakia. It may occur after an uncomplicated cataract extraction, but it is seen more often if vitreous humor has been lost during surgery. (Dorland, 27th ed; Newell, Ophthalmology: Principles and Concepts, 7th ed, p310-12). Retinal Pigment Epithelial Detachment,Detachment, Retinal,Detachments, Retinal,Retinal Detachments
D004848 Epithelium The layers of EPITHELIAL CELLS which cover the inner and outer surfaces of the cutaneous, mucus, and serous tissues and glands of the body. Mesothelium,Epithelial Tissue,Mesothelial Tissue,Epithelial Tissues,Mesothelial Tissues,Tissue, Epithelial,Tissue, Mesothelial,Tissues, Epithelial,Tissues, Mesothelial
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

Related Publications

D Sirbat, and E Saudax, and B Hurault de Ligny, and E Hachet, and A Raspiller
January 1992, Journal francais d'ophtalmologie,
D Sirbat, and E Saudax, and B Hurault de Ligny, and E Hachet, and A Raspiller
January 2005, Oftalmologia (Bucharest, Romania : 1990),
D Sirbat, and E Saudax, and B Hurault de Ligny, and E Hachet, and A Raspiller
April 2011, Pediatrics international : official journal of the Japan Pediatric Society,
D Sirbat, and E Saudax, and B Hurault de Ligny, and E Hachet, and A Raspiller
April 2005, Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie,
D Sirbat, and E Saudax, and B Hurault de Ligny, and E Hachet, and A Raspiller
January 1991, Bulletin de la Societe belge d'ophtalmologie,
D Sirbat, and E Saudax, and B Hurault de Ligny, and E Hachet, and A Raspiller
January 1966, Transactions - American Academy of Ophthalmology and Otolaryngology. American Academy of Ophthalmology and Otolaryngology,
D Sirbat, and E Saudax, and B Hurault de Ligny, and E Hachet, and A Raspiller
January 1975, International ophthalmology clinics,
D Sirbat, and E Saudax, and B Hurault de Ligny, and E Hachet, and A Raspiller
January 1990, Bulletin des societes d'ophtalmologie de France,
D Sirbat, and E Saudax, and B Hurault de Ligny, and E Hachet, and A Raspiller
February 2005, Acta ophthalmologica Scandinavica,
D Sirbat, and E Saudax, and B Hurault de Ligny, and E Hachet, and A Raspiller
December 1978, Bulletin des societes d'ophtalmologie de France,
Copied contents to your clipboard!