New therapies with potential neuro-ophthalmologic toxicity

Given the ever-increasing number of drugs available for the treatment of a variety of ocular and systemic disorders, it is not surprising that neuro-ophthalmologic complications are being recognized with increasing frequency. In this chapter, we describe both previously unreported (or rarely described) neuro-ophthalmologic complications produced by well known medications and neuro-ophthalmologic complications produced by new medications. The medications discussed include antidepressants, antiepileptic medications, topical antiglaucoma medications, and chemotherapeutic/immunosuppressive agents. Most of the side effects produced by these medications affect visual sensory function; however, some produce disturbances of ocular motility and alignment. Some of these effects are related directly to drug toxicity, whereas others are related to secondary effects of the drug. The heterogeneity of the pathogenesis of side effects from these drugs explains why some of the side effects are reversible, whereas others are not.