Dapsone-induced optic atrophy: a rare case report

Abstract

Dapsone-induced optic atrophy (OA) is very rare at therapeutic doses. A 43-year-old gentleman on WHO-recommended multibacillary Multi-Drug Therapy (WHO MB-MDT) containing rifampicin, dapsone, and clofazimine, presented with bilateral gradual painless diminution of vision after 3 months of medication. He denied any history of trauma, headache, limb weakness, ataxia, diplopia, temporal pain , or weight loss. There was no history of sudden diminution of vision in family members. Fundus examination showed bilateral pale optic discs with well-defined margins. Glucose-6-phosphate dehydrogenase (G6PD) was normal. He was diagnosed with OA secondary to dapsone. There is therefore a possibility of dapsone induced OA even at the therapeutic dose. Hence, we should perform routine eye check-up before starting dapsone.