Visual Snow-Like Symptoms, Ellipsoid Zone Disruption, and Outer Retinal Pigmentary Changes in a Patient with Chronic Kratom Use: A Case Report.

Q3 Medicine

Retinal Cases and Brief Reports Pub Date : 2026-07-16 DOI:10.1097/ICB.0000000000001959

Lily C Farrell, Jose S Pulido, Yoav J Gutterman, Rebecca S Simstein, Justin C Muste

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引用次数: 0

Abstract

Purpose: To report a novel case of kratom ( Mitragyna speciosa )-associated ocular toxicity presenting with visual snow and ellipsoid zone disruption, expanding the known ophthalmic complications of chronic kratom use.

Methods: A case report and literature review were performed.

Results: A 70-year-old man with 4 years of daily kratom use (6.8 g daily) presented with worsening nyctalopia and a visual snow-like phenomenon. OCT showed bilateral ellipsoid zone disruption and peripheral RPE changes. Fundus autofluorescence showed macular hypo-autofluorescence. Indocyanine Green and Fluorescein Angiographies were unremarkable. ERG was also unremarkable. His MRI showed chronic, nonspecific age-related changes. Cutaneous hyperpigmentation was also noted. Urine mitragynine was positive.

Conclusions: This case raises the possibility that chronic kratom use may be associated with visual snow-like symptoms, ellipsoid zone disruption, and RPE changes. Consider multimodal retinal imaging in chronic users, especially with dermatologic signs. More studies are needed to define kratom's ocular toxicity profile.

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慢性Kratom使用患者的视觉雪样症状，椭球区破坏和视网膜外色素改变：1例报告。

目的：报告一例新的克拉通（Mitragyna speciosa）相关的眼毒性，表现为视觉积雪和椭球区破坏，扩大了已知的慢性克拉通使用的眼部并发症。方法：进行病例报告和文献复习。结果：1例70岁男性，每日服用克拉通4年（每日6.8 g），夜盲症加重，出现视觉雪样现象。OCT显示双侧椭球区破裂和周围RPE改变。眼底自身荧光显示黄斑低自身荧光。吲哚菁绿和荧光素血管造影无明显差异。ERG也不显著。他的核磁共振显示慢性非特异性年龄相关变化。皮肤色素沉着也被注意到。尿中米特拉吉宁呈阳性。结论：本病例提示长期使用克拉通可能与视觉雪样症状、椭球区破坏和RPE改变有关。考虑慢性使用者的多模态视网膜成像，特别是有皮肤症状的患者。需要更多的研究来确定kratom的眼部毒性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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