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Linezolid-induced optic neuropathy: a mitochondrial disorder?
M Javaheri1, R N Khurana, T M O'hearn
1Department of Ophthalmology, Doheny Eye Institute, Keck School of Medicine, University of Southern California, 1450 San Pablo Street DEI 5802, Los Angeles, CA 90033, USA.
The British Journal of Ophthalmology
|December 21, 2006
Summary
Long-term linezolid treatment can cause mitochondrial optic neuropathy. Prompt discontinuation of linezolid is crucial for vision recovery and preventing permanent vision loss.
Area of Science:
- Ophthalmology
- Neurology
- Pharmacology
Background:
- Linezolid is an antibiotic used for serious infections.
- Long-term use has been associated with toxicities, including optic neuropathy.
- Mitochondrial dysfunction is a proposed mechanism for linezolid-induced optic neuropathy.
Observation:
- A 6-year-old boy developed bilateral optic neuropathies after 1 year of linezolid treatment.
- Initial presentation included severe vision loss (20/400), optic disc edema, and retinal nerve fiber layer swelling.
- Clinical and optical coherence tomography (OCT) findings documented the optic nerve changes.
Findings:
- Discontinuation of linezolid led to rapid visual improvement within 2 weeks.
- Full visual recovery (20/20) was achieved by 3 months post-treatment.
- OCT confirmed resolution of swelling and development of mild optic disc pallor, indicating partial recovery.
Implications:
- Clinicians must monitor for visual disturbances in patients on long-term linezolid.
- Early detection and discontinuation of linezolid can prevent irreversible vision loss.
- This case highlights linezolid-induced optic neuropathy as a form of mitochondrial optic neuropathy.
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