Optic Neuropathy in Patients Using Amiodarone

Purvin, Valerie A.; Kawasaki, Aki; Borruat, François‐Xavier

doi:10.1001/archopht.124.5.696

Cited by 59 publications

(44 citation statements)

References 11 publications

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“…To clarify the association, Macaluso et al 67 summarized the data from 73 patients, including 16 published case reports and 57 patients with information recorded in the National Registry of Drug-Induced Ocular Side Effects, with optic neuropathy associated with amiodarone use. These authors emphasized, as have Purvin et al, 68 that those patients most likely to have an amiodarone-related NAION are those in which the condition is bilateral, has an insidious onset, and is characterized by generalized rather than altitudinal visual field loss as well as chronic optic disc swelling persisting months rather than weeks after onset of visual loss.…”

Section: Risk Factorsmentioning

confidence: 91%

Current concepts in the diagnosis, pathogenesis and management of nonarteritic anterior ischaemic optic neuropathy

Miller

Arnold

2014

Eye

191

139

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Nonarteritic anterior ischaemic optic neuropathy (NAION) is the most common acute optic neuropathy in patients over the age of 50 and is the second most common cause of permanent optic nerve-related visual loss in adults after glaucoma. Patients typically present with acute, painless, unilateral loss of vision associated with a variable visual field defect, a relative afferent pupillary defect, a swollen, hyperaemic optic disc, and one or more flame-shaped peripapillary retinal haemorrhages. The pathogenesis of this condition is unknown, but it occurs primarily in patients with structurally small optic discs that have little or no cup and a variety of underlying vascular disorders that may or may not be known at the time of visual loss. There is no consistently beneficial medical or surgical treatment for the condition, but there are now animal models that allow testing of various potential therapies. About 40% of patients experience spontaneous improvement in visual acuity. Patients in whom NAION occurs in one eye have a 15-19% risk of developing a similar event in the opposite eye over the subsequent 5 years.

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Section: Risk Factorsmentioning

confidence: 91%

Current concepts in the diagnosis, pathogenesis and management of nonarteritic anterior ischaemic optic neuropathy

Miller

Arnold

2014

Eye

191

139

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“…The abnormalities of VEPs were consistent with an optic neuropathy (ON) [5,6,[8][9][10][11]. In both cases, the past medical history was significant for hypertension as well as for intermittent paroxysmal supraventricular tachycardia and atrial fibrillation.…”

Section: Discussionmentioning

confidence: 89%

“…In experimental animals, amiodarone was found to induce necrosis and denervation atrophy in the muscles, thus explaining the clinical observation of delay in motor recovery [3,4]. Ocular side-effects of amiodarone are well known [5,[8][9][10][11]; the most common is the keratopathy manifested as corneal epithelial deposits, which has been reported in 33%-100% of patients taking amiodarone. These deposits do not cause visual loss nor do they result in permanent damage to corneal tissues; they usually disappear with cessation of amiodarone [5,6].…”

Section: Discussionmentioning

confidence: 99%

“…These deposits do not cause visual loss nor do they result in permanent damage to corneal tissues; they usually disappear with cessation of amiodarone [5,6]. The ON in patients on amiodarone therapy is a recognized, although infrequently observed, phenomenon [1,[8][9][10][11]. Although the degree to which the eyes are affected is quite variable, there is a higher rate of bilateral involvement, which may cause serious and permanent effects on vision [8][9][10].…”

Section: Discussionmentioning

confidence: 99%

“…Side effects of anti-arrhythmic drugs may affect thyroid, lung, liver, eyes, central, and peripheral nervous system [1][2][3][4][5][6][7][8][9][10][11]. Amiodarone hydrochloride, the most commonly prescribed anti-arrhythmic drug, is an iodinated benzofuran derivative prescribed at recommended dose of 200 mg daily; its direct action is to prolong repolarization and refractoriness in cardiac tissues, including the sinus, the atrium,the atrioventricular nodes, and the Purkinje system [1,5,6].…”

Section: Introductionmentioning

confidence: 99%

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Amiodarone neurotoxicity: the other side of the medal

2014

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AbstractThe efficacy of amiodarone is tempered by its toxicity, with 50% of long-term users discontinuing the drug. The non-cardiac side effects of amiodarone may involve central and peripheral nervous system. We studied two patients treated with amiodarone for 46 and 15 months respectively. Both patients exhibited progressive distal extremity weakness, impaired perception, loss of deep reflexes. Electrophysiology identified a widespread, sensorimotor polyneuropathy with features of axonal loss and demyelination. Visual evoked potentials (VEPs) showed prolonged P100 latency bilaterally in absence of visual symptoms or brain magnetic resonance imaging (MRI) abnormalities. Extensive laboratory examinations excluded known causes of peripheral neuropathies. At 21 months after amiodarone withdrawal, P100 latency of case 1 VEPs returned to normal, whereas polyneuropathy continued to progress. In the second patient neuropathy has worsened similarly over 2 years whereas P100 latency of VEPs recovered to normal within 7 months after withdrawal of amiodarone. These findings may suggest different mechanisms of toxicity, which could be due to amiodarone pharmacokinetic and its metabolite effects on the peripheral nerves, as opposed to the optic nerve. We emphasize that use of amiodarone needs monitoring of patients at risk of development side effects.

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Current awareness: Pharmacoepidemiology and drug safety

2006

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 20 sections: 1 Books, Reviews & Symposia; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Optic Neuropathy in Patients Using Amiodarone

Cited by 59 publications

References 11 publications

Current concepts in the diagnosis, pathogenesis and management of nonarteritic anterior ischaemic optic neuropathy

Current concepts in the diagnosis, pathogenesis and management of nonarteritic anterior ischaemic optic neuropathy

Amiodarone neurotoxicity: the other side of the medal

Current awareness: Pharmacoepidemiology and drug safety

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