Amiodarone-associated Optic Neuropathy—A Clinical Criteria–based Diagnosis?

Fasler, Katrin; Traber, Ghislaine L.; Jaggi, Gregor P.; Landau, Klara

doi:10.1080/01658107.2017.1340961

Cited by 9 publications

(3 citation statements)

References 33 publications

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“…It is not entirely clear why incidences of ocular surface lesions were higher among patients who received cardiac drugs (amiodarone, cardiac glycosides, beta-blockers), antibiotics (penicillin, rifampicin, metronidazole), and anticoagulants (rho = 0.424, p < 0.001). Studies have shown the presence of toxic neuropathy after amiodarone, but this was true for long-term treatment (several months), and was not associated with damage to the eye's surface [38][39][40]. Similarly, the relationship between the use of beta-blockers and cataracts has been shown [41,42], but also after longer treatment periods.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Eye Complications in Patients Treated in the Intensive Care Unit

Płaszewska‐Żywko

Sega

Bukowa

et al. 2021

IJERPH

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In critically ill patients, normal eye protection mechanisms, such as tear production, blinking, and keeping the eye closed, are impaired. In addition, many other factors related to patients’ severe condition and treatment contribute to ocular surface disease. Reducing risk factors and proper eye care can have a significant impact on incidences of eye complications and patient quality of life after discharge from the intensive care unit (ICU). The aim of the study was to determine risk factors for ocular complication, especially those related to nursing care. The study was conducted in the ICU of a university hospital. Methods for estimating and analyzing medical records were used. The patient’s evaluation sheet covering 12 categories of risk factors for eye complications was worked out. The study group included 76 patients (34 patients with injuries and 42 without injuries). The Shapiro–Wilk test, the Spearman’s rank correlation test, the Mann–Whitney U test and the Friedman’s ANOVA test were used. The level of significance was set at α = 0.05. The most important risk factors for eye complications in the study group were: lagophthalmos (p < 0.001), sedation (p < 0.01), use of some cardiological drugs and antibiotics (p < 0.01), mechanical ventilation (p < 0.05), use of an open suctioning system (p < 0.01), presence of injuries (p < 0.01) including craniofacial trauma (p < 0.001), high level of care intensity (p < 0.01), failure to follow eye care protocol (p < 0.001), length of hospitalization at the ICU (p < 0.001), and the frequency of ophthalmological consultations (p < 0.001). There was no correlation between the incidence of these complications and the age and gender of the patients. The exposure of critically ill patients to eye complications was high. It is necessary to disseminate protocols and guidelines for eye care in ICU patients to reduce the risk factors.

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Section: Discussionmentioning

confidence: 99%

Risk Factors of Eye Complications in Patients Treated in the Intensive Care Unit

Płaszewska‐Żywko

Sega

Bukowa

et al. 2021

IJERPH

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“…In 2017, Fasler et al applied the diagnostic framework reported by Purvin et al in a retrospective chart review of 13 patients with suspected optic neuropathy related to amiodarone therapy between 1995 and 2015 [ 21 ]. Exclusion criteria included other plausible causes of optic neuropathy and incomplete information related to amiodarone therapy and dosing.…”

Section: Refining Diagnostic Criteria For Aaonmentioning

confidence: 99%

Clinical and Mechanistic Review of Amiodarone-Associated Optic Neuropathy

Mitchell

Chacko

2022

Biomolecules

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Amiodarone-associated optic neuropathy (AAON) is a complex clinical diagnosis, requiring distinction from non-arteritic ischemic optic neuropathy (NAION) due to a shared at-risk patient population. Diagnosis of AAON is complicated by a varied clinical presentation and incomplete pathophysiologic mechanisms. This article reviews pertinent literature for describing and clinically delineating AAON from NAION, as well as newly reported protective mechanisms of insulin-like growth factor 1 (IGF-1) and PI3K/Akt against amiodarone-induced oxidative and apoptotic injury in retinal ganglion and pigment epithelial cells. These studies offer a basis for exploring mechanisms of amiodarone toxicity in the optic nerve.

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“…2 , 3 , 4 Previous studies have shown that older age, male sex, white race, retinal venous occlusive disease, age-related macular degeneration, hypercoagulable states, hypertension, hypercholesterolemia, diabetes mellitus, cardiac disease, cerebrovascular disease, obstructive sleep apnea, amiodarone and phosphodiesterase 5 inhibitor use, systemic hypotension and optic disc drusen are risk factors for developing NAION. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 20 Migraine has been thought to be an additional risk factor for younger patients. 4 While the exact pathogenesis is largely controversial, NAION is presumed to result from a hypoperfusion to the short posterior ciliary arteries that supply the optic nerve head, resulting in ischemia, optic nerve head edema, focal infarction, and consequent atrophy.…”

Section: Introductionmentioning

confidence: 99%