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[Amiodarone induced retrobulbar neuritis. Clinical case]
J Bartolucci1, P Ibáñez, C Verdugo
1Departamento de Cardiología, Hospital Dr. Gustavo Fricke, Facultad de Medicina, Universidad de Valparaíso, Chile. bart1-kong2@entelchile.net
Insights
This case report highlights a potential adverse effect of amiodarone, an antiarrhythmic drug. The patient experienced vision changes, including visual field loss, after treatment, suggesting amiodarone-induced optic neuropathy.
Area of Science:
- Ophthalmology
- Cardiology
- Pharmacology
Background:
- A 66-year-old male with coronary heart disease and long sightedness presented with paroxysmal atrial fibrillation.
- Treatment involved intravenous amiodarone at a total dose of 6g over 72 hours.
Observation:
- The patient initially noted improved long sightedness after three days of amiodarone treatment.
- Subsequently, blurred vision, frontal headache, and visual field defects (concentric retraction, centrocecal scotoma) developed.
Findings:
- Amiodarone was discontinued, and dexamethasone treatment was initiated.
- Visual function and visual fields normalized within three days of amiodarone withdrawal.
Implications:
- This case suggests amiodarone may be a potential cause of retrobulbar optic neuritis.
- Further investigation is warranted to establish a causal link between amiodarone and optic neuropathy.
Abstract:
We report a 66 years old male, with an ophtalmologic history of long sightedness, admitted to the hospital due to paroxysmal atrial fibrillation crises in the context of a coronary heart disease. He was treated with i.v. amiodarone, receiving a total dose of 6 g in 72 hours. After the third day of treatment, the patient noticed a correction of his long sightedness and 24 h later, he complained of hlurred vision and orbital frontal headache. Visual field examination revealed a concentric retraction of visual field and a centrocecal scotoma in both eyes. Amiodarone was withdrawn and dexametasone treatment was begun. Three days after amiodarone discontinuation, sight improved and visual field returned to normal. Although retrobulbar neuritis has been associated to various drugs, amiodarone has not been considered as a possible agent.