Crystalline Retinopathy Associated With Long-term Nitrofurantoin Therapy

Intraretinal crystalline deposition has been seen in association with several systemic and ocular diseases, as well as following exposure to a variety of exogenous drugs and other substances. We have recently encountered a patient with intraretinal crystals and slightly decreased visual acuity in association with a 19-year history of daily use of nitrofurantoin. Report of a Case. A 69-year-old man noted gradual bilateral decrease in vision over 5 to 7 months. His medical history was unremarkable except for benign prostatic hypertrophy and recurrent urinary tract infections treated with nitrofurantoin macrocrystals (Macrodantin), 100mg/d, for 19 years (cumulative dose, 690 g). Best corrected visual acuity was 20/30 OU. Anterior segment examination was unremarkable. Posterior segment evaluation showed bilateral superficial and deep intraretinal glistening deposits distributed in a circinate pattern throughout the posterior pole, sparing the retinal periphery ( Figure ). Fluorescein angiogram, electroretinogram, and electrooculogram showed no abnormalities. He denied the use of intravenous