Intrauterine exposure to clomiphene and neonatal persistent hyperplastic primary vitreous

A 4-year-and-10-month-old girl was diagnosed shortly after birth with persi stent hyperplastic primary vitreous (PHPV). Her mother took clomiphene 100 mg daily for approximately 4 weeks and discontinued the drug once she had a positive pregnancy test. The exact time of gestation was not clear. Clomip hene is an estrogen antagonist effective in the treatment of anovulation. V arious ocular side effects have been described in women taking the drug, in cluding decreased vision, mydriasis, flashing lights, central scotoma, phot ophobia, diplopia, allergic reactions, retinal vasospasms, detachment poste rior vitreous, and possibly posterior subcapsular cataracts. These occur in 1.5-10% of patients taking clomiphene. The potential effects of clomiphene on the fetus have been investigated in five animal studies. Cataracts were observed in fetal mice and rats, but not in monkeys. In humans, a case of congenital retinal aplasia was described. The possibility of clomiphene-ind uced congenital PHPV should be considered, especially in pregnant women who are taking a high and prolonged dose. Teratology 60:143-145, 1999. (C) 199 9 Wiley-Liss, Inc.