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Spectral-Domain Optical Coherence Tomographic Imaging of Pigmented Retinal Pigment Epithelial Deposits in a Patient With Prolonged Minocycline Use

Michelle E. Wilson, MD1; Jayanth Sridhar, MD1,2; Sunir J. Garg, MD1,2; Alan R. Forman, MD1
[+] Author Affiliations
1Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
2Mid Atlantic Retina, Philadelphia, Pennsylvania
JAMA Ophthalmol. 2015;133(11):1360-1362. doi:10.1001/jamaophthalmol.2015.2819.
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This case report describes pigmented deposits in the eyes of a patient with prolonged use of minocycline for acne rosacea.

Minocycline hydrochloride is a synthetic tetracycline antibiotic used to treat conditions such as acne vulgaris, rosacea, rheumatoid arthritis, and bullous pemphigoid.1 Tetracycline antibiotics, and minocycline in particular, can cause a blue-black or slate-gray discoloration of tissues including the skin, nails, teeth, oral mucosa, thyroid, and bones.2 There are a few reported cases of minocycline-related ocular pigmentation, including reports of pigmentation of the sclera35 and conjunctiva4,6 and a single reported case of retinal pigmentation.4

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Figure 1.
Blue-Gray Discoloration of Sclera and Conjunctival Deposits

A, Blue-gray discoloration of the sclera in the right eye. B, Inferior palpebral conjunctival blue-gray deposits in the left eye.

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Figure 2.
Imaging Findings

A and B, Fundus photographs show granular, dark blue-gray perifoveal deposits (arrowheads). C and D, Spectral-domain optical coherence tomographic imaging reveals irregular elevation of the retinal pigment epithelium (arrowheads). E and F, Fluorescein angiography shows no abnormal fluorescence.

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