Morphological alterations of the retina caused by lithium have been described in rats. Human patients were therefore examined for such findings, and photophobia, neuritis affecting the optic nerves and downbeat nystagmus were observed. We found pathologic Arden quotients in the EOG, indicating an alteration of the pigment epithelium. The VEPs showed delayed latencies, whereas the amplitudes remained unchanged. Because of the pathologic electrophysiological findings ophthalmological controls, including EOG and VEP, should be performed yearly in patients taking lithium.
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