TRANSITORY BLINDNESS DURING ETHANOL AND PHENETHYLBIGUANIDE INDUCED LACTIC ACIDOSIS IN A SUBJECT WITH DIABETES MELLITUS A Case Report

Abstract

Transitory blindness is described in a diabetic patient with typical ethanol- and phenethylbiguanide induced lactic acidosis. The blindness developed in the course of 8 hours, but the vision returned during treatment with iv bicarbonate, insulin and glucose. The condition is discussed in relation to a presumed inhibition of the oxidative metabolism in the retina.

Transient Blindness in a Patient with Severe Metformin-Associated Lactic Acidosis (MALA)

“…It is not easy to distinguish between blindness related to MALA and blindness related to other causes. In previous cases, reversible blindness due to lactic acidosis was reported in diabetic patients89); a case of transient blindness due to diabetic ketoacidosis (DKA) and due to alcoholic ketoacidosis have also been reported1011). The common features of these cases were severe metabolic acidosis with pH <7.0 and bicarbonate <5.0mmol/L, and restoration of visual acuity after metabolic acidosis was corrected (Table 2).…”

Characteristics of Severe Alcoholic Ketoacidosis with a Reversible Visual Disturbance

“…There was no original report of treating such cases. Three reports were duplications; Thus a 12 case reports, including 4 English and 8 Japanese articles, were analyzed [7][8][9][10][11][12][13][14][15][16][17][18].…”