Clomiphene Citrate Associated With Palinopsia

Visual Snow: Updates and Narrative Review

PURPOSE OF REVIEW

Visual snow (VS) involves visualization of innumerable dots throughout the visual field, sometimes resembling "TV static." Patients who experience this symptom may also have additional visual symptoms (e.g., photophobia, palinopsia, floaters, and nyctalopia) with a pattern now defined as visual snow syndrome (VSS). This manuscript describes both VS and VSS in detail and provides an updated review on the clinical features, pathophysiology, and optimal management strategies for these symptoms.

RECENT FINDINGS

VS/VSS may be primary or secondary to a variety of etiologies, including ophthalmologic or brain disorders, systemic disease, and medication/hallucinogen exposure. Evaluation involves ruling out secondary causes and mimics of VS. Increasing evidence suggests that VSS is a widespread process extending beyond the visual system. Pathophysiology may involve cortical hyperexcitability or dysfunctional connectivity of thalamocortical or attention/salience networks. VSS is typically a benign, non-progressive syndrome and can be managed with non-medicine strategies. Though no medication provides complete relief, some may provide partial improvement in severity of VS.

Short-term palinopsia after three doses of clomiphene: A case report

Palinopsia is a phenomenon consisting of the persistence or recurrence of a visual image after the stimulus has been removed, and can be static or kinetic. Palinopsia can be caused by a variety of different factors. Drug-induced palinopsia usually takes the form of visual trailing, a subset of illusory palinopsia, where patients report that an object leaves after-images trailing behind the object. There have been few reported cases of clomiphene-induced palinopsia. All have led to permanent palinopsia. This report demonstrates a case of transient clomiphene-induced palinopsia. Palinopsia occurred after only three doses of clomiphene and resolved within 10 days of cessation of therapy.