Getting to the heart of visual loss: When cardiac medication may be dangerous to the optic nerves

Sedwick, Lyn A.

doi:10.1016/0039-6257(92)90114-9

Cited by 17 publications

(7 citation statements)

References 32 publications

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“…These conditions are often found in patients receiving amiodarone therapy, thus placing them in the high risk group for developing AION. As such, there has been understandable caution linking amiodarone to the development of optic neuropathy despite many case reports suggesting this is the case 2–7 . The exact incidence of optic neuropathy in patients taking amiodarone is not known but has been estimated at 1.3–1.79% 2,3 .…”

Section: Discussionmentioning

confidence: 99%

“…There have been more than 30 reports of amiodarone‐induced optic neuropathy in the literature 2–7 . Although the degree to which eyes are affected is quite variable, there is a higher rate of bilateral involvement with amiodarone‐induced optic neuropathy compared with other causes of anterior ischaemic optic neuropathy (AION) (Table 1).…”

Section: Introductionmentioning

confidence: 99%

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Clinical Case Notes

Clement

Myers²,

Tan

2005

Clinical Exper Ophthalmology

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Patients on amiodarone have an increased incidence of optic neuropathy. The unusual case is reported of a 67‐year‐old man who developed bilateral optic neuropathy 4 weeks after commencing amiodarone and then had unilateral recurrence of segmental disc swelling despite cessation. The case highlights amiodarone‐induced optic neuropathy as a different clinical entity to anterior ischaemic optic neuropathy. It is characterized by insidious onset, bilateral disease and protracted disc swelling progressing to optic atrophy. Patients that experience any visual disturbance while taking amiodarone should seek urgent ophthalmic review.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Case Notes

Clement

Myers²,

Tan

2005

Clinical Exper Ophthalmology

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“…This adverse effect is not mentioned in the BNF . Elsewhere, Sedwick discusses the possible relation between amiodarone induced and ischaemic optic neuropathy in a diabetic patient 19. Optic neuropathy is well recognised with ethambutol.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of drug induced ocular reactions in diabetes

Hampson

Harvey²

2000

British Journal of Ophthalmology

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Aims-To conduct a systematic review of drug induced adverse ocular eVects in diabetes to determine if this approach identified any previously unrecognised adverse drug eVects; to make a preliminary assessment of the feasibility of this approach in identifying adverse drug reactions; and to assess the current accessibility of this information to prescribing physicians. Methods-Literature search of online biomedical databases. The search strategy linked eye disorders with adverse drug reactions and diabetes. Source journals were classified as medical, pharmaceutical, diabetes related, or ophthalmological. It was determined whether the reactions identified were recorded in drug datasheets and the British National Formulary. Results-63 references fulfilled the selection criteria, of which 45 were considered to be relevant to the study. The majority of these were case reports but cross sectional surveys, case-control and cohort studies, and review articles were also identified. 61% of the reactions were not recorded in the British National Formulary and 41% were not recorded in the datasheets. 55% appeared in specialist ophthalmology journals. Conclusions-This is a feasible approach to the identification of adverse drug reactions. Adverse reactions not listed in the most commonly used reference sources were found. The majority were published in specialist ophthalmology journals which might not be seen by prescribing physicians. (Br J Ophthalmol 2000;84:144-149)

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“…Since 1987, more than 100 cases of this association have been reported. [2][3][4][5][6][7][8] Along with this growing number of reports, a recent $22.3 million lawsuit against a pharmaceutical company for failing to list optic neuropathy as a potential side effect of amiodarone has increased awareness of this entity as a potential and legitimate adverse drug reaction (ADR). [9][10][11] The optic neuropathy associated with amiodarone shares some features of non-arteritic anterior ischemic optic neuropathy (NAION).…”

Section: Introductionmentioning

confidence: 99%

Bilateral Sequential Vision Loss in a Patient Re-Challenged with Amiodarone

Faulkner

Katz

Sykes³

et al. 2008

Neuro-Ophthalmology

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Optic neuropathy with vision loss is an uncommon but serious event currently considered a probable amiodarone-associated adverse drug reaction. We report a case of a 72-year-old woman with irreversible, bilateral, and sequential vision loss experienced while taking amiodarone. This case involves challenge, discontinuation and subsequent rechallenge with amiodarone. It provides evidence for reclassifying optic neuropathy as a certain adverse drug reaction. Despite relatively low incidence of vision loss in patients receiving amiodarone, we agree with recommendations of baseline and periodic ophthalmic examinations during therapy. Due to potentially irreversible vision loss, patients taking amiodarone should seek medical attention for visual changes.

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Getting to the heart of visual loss: When cardiac medication may be dangerous to the optic nerves

Cited by 17 publications

References 32 publications

Clinical Case Notes

Clinical Case Notes

A systematic review of drug induced ocular reactions in diabetes

Bilateral Sequential Vision Loss in a Patient Re-Challenged with Amiodarone

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