Potassium Iodate Retinotoxicity after an Overdose of Anti-Radiation Pills: A Case of Apocalyptic Retinopathy.

Abstract

To report a case of severe retinal toxicity after an attempted suicidal overdose of anti-radiation pills containing a well-known retinal pigment epithelial toxin, potassium iodate. Clinical examination and multimodal imaging are provided from a clinic visit eleven years after the suicide attempt. The 42-year-old patient had widespread retinal atrophy in both eyes with near complete absence of the retinal pigment epithelium and severe retinal thinning. A few remaining areas of preserved photoreceptors provided her with 20/60 and 20/200 vision in her right and left eyes, respectively, with very constricted visual fields. Despite being first described over 100 years ago, few cases of iodate retinotoxicity have been reported in the published literature, and most are related to accidental or intentional ingestion of iodate salts used to iodize table salt. This unique case of iodate retinotoxicity secondary to anti-radiation tablets highlights the risks of unregulated sale of these agents marketed in the United States as essential components of nuclear apocalypse "go bags" because they have a poor margin-of-safety and no specific warnings of the risk of permanent blindness with overdosage.