gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Solar retinopathy as visual threatening side effect with intake of Hypericum perforatum

Meeting Abstract

Suche in Medline nach

  • corresponding author R. Lämmer - Augenklinik mit Poliklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
  • C.Y. Mardin - Augenklinik mit Poliklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogP 186

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dog2004/04dog677.shtml

Veröffentlicht: 22. September 2004

© 2004 Lämmer et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Photosensitisation effects are known for furanocumarines occurring in different herbal families. The presented case report describes an acquired solar retinopathy with intake of Hypericum perforatum essence.

Casuistic

A 39-year-old patient was presented to our clinic with sudden visual degradation since 3 days left more than right. Visual acuity was 0.6 for the right and 0,3p for the left eye. Clinically a white and yellowish lesion of the fovea centralis appeared with positive Watzke test. Fluorescein angiography showed a regular result. With focused medical history the patient reported of the intake of Saint-Johns-wort extract because of a depression. Additionally the patient indicated to have looked into the sun 3 days ago through a fly screen for a long time.

Disscusion

The therapeutic insertion of Hypericum perforatum can be traced back to the early antiquity. As herbal medicine Saint-John-wort is widely used because of postulated rare side effects and is as prescription free drug available in Germany in about 50 preparations on the market. The Phloroglucinderivate Hyperforin (Hypericin) is discussed as the active substance that blocks neural intake of dopamine, GABA and glutamate. As well as induction of the Cytochrom P-450 complex photosensitisation effects are to be considered.

Conclusions

Basic knowledge of side effects of often in clinical practice used medicine is essential. With prescription free medicine a special responsibility comes up druggist and patient. However, this can be limited especially with psychologically unstable patients. Photosensitisation effect of Hypericum perforatum can lead to a solar retinopathy also in winter months and without solar eclipse.