Keratopathy after oral administration of tilorone hydrochloride

Two patients given tilorone HCl orally for varying periods of time had clinical and histopathologic ocular changes. Retrospective study of 14 cancer patients who were taking tilorone HCl orally revealed that three patients had similar ophthalmic findings accompanied by the appearance of blue halos around pinpoint light sources. Examination revealed a diffuse clouding of the epithelium sometimes associated with subepithelial infiltrates. Abnormalities seen histologically included cloudy swelling of the epithelium and cytoplasmic inclusions. By electron microscopy these were found to be myelinoid bodies. Gas chromatography and mass spectrophotometry showed that tilorone HCl was present in the cornea and conjunctiva. Visual acuity was not affected and these changes were slowly reversible with the cessation of therapy. Biomicroscopic and conjunctival cytologic examination may serve to indicate the drug's storage and potential damage in the body.