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[Optic neuropathy caused by amiodarone].

J L Ferreiro1, J A Isern Longares, A F Ramón Moya

  • 1División de Neurología, Hospital José de San Martín, Buenos Aires, Argentina.

Neurologia (Barcelona, Spain)
|May 1, 1990
PubMed
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Prolonged amiodarone use can cause optic neuropathy, leading to decreased visual acuity. This drug-induced demyelination may affect lipid metabolism, similar to iatrogenic lipidoses.

Area of Science:

  • Ophthalmology
  • Neurology
  • Pharmacology

Background:

  • Amiodarone, an antiarrhythmic and antianginal drug, has been in use for two decades.
  • Potential adverse effects of amiodarone include optic neuropathy, though it is not a frequent complication.

Observation:

  • Two patients treated with a mean daily dose of 250 mg of amiodarone for approximately 17 months experienced reduced visual acuity.
  • Optic neuropathy was identified as a potential complication in these patients.

Findings:

  • The study suggests a link between prolonged amiodarone ingestion and observed optic alterations.
  • This optic neuropathy is hypothesized to be a demyelination neuropathy induced by amiodarone.
  • Ultrastructural changes in animal optic nerves treated with amiodarone resemble those in peripheral nerves, indicating a lipid metabolism disorder.

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Implications:

  • Amiodarone-induced optic neuropathy may be categorized under iatrogenic lipidoses due to its effect on lipid metabolism.
  • Clinicians should consider optic neuropathy in patients on long-term amiodarone therapy presenting with visual disturbances.