Case Report: IVCM of corneal chlorpromazine toxicity drug deposits

To investigate corneal deposits in a patient undergoing long-term chlorpromazine therapy using <i>in vivo</i> confocal microscopy with the HRT II Rostock Corneal Module. We reported a 45-year-old woman with a 7-year history of chlorpromazine therapy presented with bilateral photophobia and a 4-year history of gradual-onset blurred vision. Slit-lamp examination revealed yellowish deposits in the corneal endothelium and Descemet's membrane. <i>In vivo</i> confocal microscopy identified irregular hyper-reflective deposits in all corneal layers. The epithelial and superficial stromal deposits had well-defined edges, while the posterior stromal, Descemet's membrane, and endothelial deposits appeared as hollow granules and streaks. This study is the first to use <i>in vivo</i> confocal microscopy to identify crystalline deposits in the corneal stroma and endothelium caused by high-dose chlorpromazine. These findings offer new insights into drug metabolism on the ocular surface and provide a basis for future research.