Reactions 1302 - 22 May 2010

★Fenetylline

First report of retinal vein occlusion: 3 casereports

Three men developed central retinal vein occlusion(CRVO) while receiving the CNS stimulant fenetylline[indication and dosage not stated].

A 33-year-old man had been taking fenetylline for5 weeks. He presented with decreased vision anddistortion in the left eye for 1 week. His visual acuitywithout correction was 1.25 in the right eye and 1.0 in theleft eye. Tension was 15mm Hg in both eyes. Fundusexamination of the left eye was typical for CRVO, revealingdisc oedema, scattered retinal haemorrhages and engorgedtortuous veins. CRVO and macular oedema in the left eyewas confirmed on fluorescein angiography. A week later,the patient reported deteriorating vision. His visual acuityin the affected eye was 0.3. The man was advised todiscontinue fenetylline. He received grid laser treatment tothe macula and was prescribed prednisolone andranitidine. He experienced a noticeable improvement in hisfundus pictures and visual acuity in the left eye increased to0.8.

A 44-year-old man presented with a 1-week history ofvisual disturbances in the right eye 1 day after taking1.5 fenetylline tablets [dosage not stated], which headmitted using on an irregular basis. He had a BP of150/80mm Hg, visual acuity of 1.0 in both eyes and tensionof 18mm Hg. Fundus examination of the right eye showedretinal haemorrhage and disc oedema. The man wasadvised to stop taking fenetylline. He was prescribedprednisolone and ranitidine, and his symptoms resolvedwithin 1 month.

A 37-year-old man presented with a 2-week history ofsudden vision loss in the right eye 1 day after taking1.5 fenetylline tablets. His symptoms had graduallyimproved over the 2-week period, but he felt that his righteye was still abnormal. His visual acuity without correctionwas 1.0 and tension was 16mm Hg in both eyes. Fundusexamination revealed engorged veins, scattered retinalhaemorrhages and hyperaemia in the right eye disc. His BPwas 130/100mm Hg. The man was advised to stop takingfenetylline and his symptoms resolved spontaneously.

Author comment: "We feel that ingestion of [fenetylline]most probably is the cause of retinal vein occlusion in thesecases. Elevated blood pressure in two of these cases maysupport this."Al-Ghadyan A, et al. Fenethylline as a possible etiology for retinal vein occlusion.Annals of Ophthalmology 41: 199-202, Jun 2009 - Saudi Arabia 803014095

» Editorial comment: A search of AdisBase, Medline,Embase and the WHO ADR database did not reveal anyprevious case reports of retinal vein occlusion associatedwith fenetylline.

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Reactions 22 May 2010 No. 13020114-9954/10/1302-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved