Ocular quinine toxicity

Abstract

A 25-year-old woman had no light perception in either eye 14.5 hours after ingesting 3.7 to 4.7 g of quinine. Fundus photographs showed mild venous distention and retinal haziness, but normal arteries. The electroretinogram, electrooculogram, and visual-evoked potential were all mildly abnormal. Two days after the patient ingested quinine, her visual acuity returned to 6/6 (20/20) with a markedly constricted visual field. The classic late fundus appearance of quinine toxicity, marked vascular narrowing, and disk pallor developed within six months. Visual fields remained constricted to 12 degrees with small temporal islands.