Medications Damaging Vascular Bed or Causing Microvasculopathy / Occlusion-2: Pathogenesis, Diagnosis, and Treatment (Gemcitabine, Fludarabine, Oral contraceptives, Heparin, Cocaine)

Abstract

Retinal toxicity can be observed during treatment with many systemic drugs and addictive substances used today. The drugs show their effects on the retina by different mechanisms such as direct toxicity to the retina and retina pigment epithelium, crystalline retinopathy, photoreceptor dysfunction, cystoid macular edema, central serous chorioretinopathy, uveitic effects, and vascular dysfunction. Vascular dysfunction, which is an important subgroup, occurs due to the direct effect of drugs on endothelium, increase in prothrombotic factors, and formation of immunocomplex and vasoconstrictive effects. The primary step in the treatment is to cease the causative agent and replace it with an alternative. In addition, medical or intravitreal injection treatments should be applied according to the retinal vascular pathology.