Ocular Adverse Effects of Amiodarone: A Systematic Review of Case Reports

Abstract

SIGNIFICANCE Amiodarone is an excellent antiarrhythmic medication; however, it has numerous systemic and ocular adverse effects. PURPOSE We aimed to improve our understanding of amiodarone and its ocular adverse effects by performing a systematic review and meta-analysis of published case reports. METHODS This systematic review was reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We used the MEDLINE database, primarily through PubMed, and used keywords (amiodarone, eye, eye diseases, visual/ocular adverse effects/manifestations) to identify case reports of ocular adverse effects after amiodarone use. The initial search resulted in 92 total case reports. However, after excluding nonrelevant case reports, 25 cases were selected for the final analysis. RESULTS Among the patients in the 25 case reports, 18 were male (72%), and the median age was 66 ± 9.9 years. In 15 cases (60%), the patients reported halos around light and/or decrease in vision after amiodarone use. The most common ophthalmic examination findings were cornea verticillata/vortex keratopathy in 19 cases (76%), followed by different patterns of papilledema and retinal hemorrhages in 5 cases (20%). Discontinuation of amiodarone was the most common intervention, followed by application of topical heparin. Outcomes among case reports were variable. CONCLUSIONS Cornea verticillata/vortex keratopathy was the most common ocular adverse effect in cases where amiodarone was administered. Early recognition of amiodarone-induced ocular adverse effects is imperative to prevent worsening keratopathy or uncommon adverse effects. Collaboration between physicians prescribing amiodarone—to recognize the ocular symptoms—and referral to eye care physicians are important.

Exogen bedingte Retinopathien

“…Es ist wichtig, Patienten bei Ethambutol-Therapie darauf hinzuweisen, sich bei subjektiven Symptomen zeitnah untersuchen zu lassen, da nur ein rasches Umsetzen der Therapie in der Regel zu einer Funktionserholung führt. Amiodaron (Herzrhythmusstörungen) ist in maximal 1,5 % der Fälle mit einer schleichend oder plötzlich beginnenden beidseitigen Visusminderung mit oder ohne Papillenödem assoziiert [31]. Der Beginn ist am häufigsten nach ca.…”

Exogen bedingte Retinopathien

“…Amiodaron (Herzrhythmusstörungen) ist in maximal 1,5% der Fälle mit einer schleichend oder plötzlich beginnenden beidseitigen Visusminderung mit oder ohne Papillenödem assoziiert 31 . Der Beginn ist am häufigsten nach ca.…”

Effect of Amiodarone on Rabbits' Optic Nerve and the Ameliorative Effect of Vitamin E: Ftir Study

“…These adverse amiodarone effects have been connected to the drug's dose, duration of administration, and the long elimination half-life. The toxicity of amiodarone is ubiquitous and affects the lungs [7], liver [8], kidneys [9], thyroid [10], skin [11] and ocular system [12]. It also induces oxidative stress by increasing mitochondrial H2O2 synthesis and reducing the hepatic ATP content [13].…”