An old friend revisited: chloramphenicol optic neuropathy

Wong, Sui Chien; Silva, F; Acheson, JF; Plant, GT

doi:10.1177/2042533313476692

Cited by 10 publications

(4 citation statements)

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“…In addition to its adverse effects on the bone marrow, chloramphenicol has shown time- and dose-dependent negative effects on the optic nerve, potentially leading to toxic optic nerve neuropathy (TON). Chloramphenicol is believed to inhibit mitochondrial protein synthesis, leading to mitochondrial respiratory chain dysfunction and disrupting B vitamin metabolism [ 82 ]. Animal studies using a mouse model have shown that a short period of high-dose chloramphenicol therapy can lead to optic nerve damage at the ultrastructural level [ 83 ].…”

Section: Posterior Segment Of the Eyementioning

confidence: 99%

Ocular Changes in Cystic Fibrosis: A Review

Liberski,

Confalonieri,

Cofta

et al. 2024

IJMS

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Cystic fibrosis (CF), also known as mucoviscidosis, is the most common autosomal recessive genetic disease in the Caucasian population, with an estimated frequency of 1:2000–3000 live births. CF results from the mutation of the cystic fibrosis transmembrane conductance regulator (CFTR) gene localized in the long arm of chromosome 7. The product of CFTR gene expression is CFTR protein, an adenosine triphosphate (ATP)-binding cassette (ABC) transporter that regulates the transport of chloride ions (Cl−) across the apical cell membrane. Primary manifestations of CF include chronic lung and pancreas function impairment secondary to the production of thick, sticky mucus resulting from dehydrated secretions. It is well known that CF can cause both anterior and posterior ocular abnormalities. Conjunctival and corneal xerosis and dry eye disease symptoms are the most characteristic manifestations in the anterior segment. In contrast, the most typical anatomical and functional changes relating to the posterior segment of the eye include defects in the retinal nerve fiber layer (RNFL), vascular abnormalities, and visual disturbances, such as reduced contrast sensitivity and abnormal dark adaptation. However, the complete background of ophthalmic manifestations in the course of CF has yet to be discovered. This review summarizes the current knowledge regarding ocular changes in cystic fibrosis.

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Section: Posterior Segment Of the Eyementioning

confidence: 99%

Ocular Changes in Cystic Fibrosis: A Review

Liberski,

Confalonieri,

Cofta

et al. 2024

IJMS

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“…Toxic optic neuropathy (TON) secondary to systemic Chloramphenicol was first reported in 1950's [4,5]. Toxicity is thought to be treatment duration and dose dependant [6].…”

Section: Introductionmentioning

confidence: 99%

“…Optic nerve can appear normal, or hyperaemic, with optic nerve haemorrhages sometimes seen. In later stages the optic nerve often becomes pale and atrophic [5,6,8].…”

Section: Introductionmentioning

confidence: 99%

Toxic Optic Neuropathy secondary to Systemic Chloramphenicol for Septic Arthritis: Case Report

Okonkwo

2018

JPT

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Introduction – Chloramphenicol is a broad-spectrum antibiotic with excellent tissue penetration. Systemic use was popularised in the 1950s due to its affordability andease of preparation. It is now rarely used in developed countries due to its significant side effect profile including toxic optic neuropathy. Case Description – A 68-year-old female presented to a neighbouring eye department with a 2-month history of bilateral visual deterioration, initially thought to be due to cataracts. However, due to the moderate cataract density and visual acuities of 6/60 and hand movements a medical history revealed that she had been taking systemic chloramphenicol for 6 months for chronic septic arthritis following a complicated total knee replacement. Following a normal ophthalmic examination besides reduced colour vision and constricted visual fields a diagnosis of toxic optic neuropathy secondary to chloramphenicol was made. Once systemic Chloramphenicol was stopped, her vision improved to 6/24 bilaterally although subjectively did not return to baseline. Conclusion – Cataracts are a common cause of visual reduction, however, if the amount of cataract does not correlate with the extent of loss of visual acuity then an alternative cause must be considered. Early recognition of toxic neuropathy is key, as withdrawal of Chloramphenicol often results in improvement of visual symptoms.

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“…Chloramphenicol has certain desirable properties such as it is a broad spectrum antibiotic, it diffuses efficiently in the body, and does not ionize at physiological condition [14] . However, the emergence of resistance to this antibiotic and its dose related toxicity that causes aplastic anemia, leukemia, bone marrow suppression and gray baby syndrome have restricted its use [14] , [15] , [16] , [17] . Thus, formulations that increase the efficiency of chloramphenicol with concomitant reduction of its dose that can possibly avoid the severe side effects are important for efficient use of this remarkable antibiotic.…”

Section: Introductionmentioning

confidence: 99%