Ocular toxicity associated with systemic drug therapy.

Area of Science:

• Ophthalmology
• Pharmacology
• Toxicology

Background:

• The incidence of systemic drug-induced ocular side effects is rising due to new drug development.
• Accurate documentation and exclusion of alternative causes are crucial for establishing causality in drug-induced ocular toxicity.
• Systemic medications are increasingly associated with adverse ocular events.

Purpose of the Study:

• To evaluate the causality of ocular toxicity for commonly used and newly introduced systemic drugs.
• To review recent reports implicating systemic drugs in ocular toxicity.
• To summarize detection, prevention, and treatment strategies for drug-induced ocular reactions.

Main Methods:

• Systematic review of recent literature on ocular toxicity associated with systemic drugs.
• Application of toxicologic criteria to establish causality for drug-induced ocular side effects.
• Evaluation of ocular toxicity reports for specific systemic agents including cidofovir, sildenafil, vigabatrin, tamoxifen, hydroxychloroquine/chloroquine, amiodarone, and statins.

Main Results:

• High probability of causality for ocular toxicity was established for cidofovir, sildenafil, tamoxifen, hydroxychloroquine/chloroquine, and amiodarone.
• Vigabatrin and lovastatin/simvastatin showed a lower probability of causality for ocular toxicity based on the evaluated criteria.
• The review identified specific ocular toxicities linked to each evaluated drug.

Conclusions:

• Several commonly prescribed systemic drugs carry a high risk of causing ocular toxicity.
• Vigabatrin and statins (lovastatin/simvastatin) were less likely to be causative agents for ocular toxicity in this review.
• Understanding these risks is vital for clinicians to manage and prevent adverse ocular events in patients on systemic medications.