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[Amiodarone associated optic neuropathies--two cases reports].

G Van Elmbt¹, C Andris, N Collignon

¹Service d'Ophtalmologie, CHU de Liège, Liège, Belgique.

Bulletin De La Societe Belge D'Ophtalmologie

|September 27, 2007

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Two cases of amiodarone-induced papilledema occurred within months of treatment, preceding corneal toxicity. This highlights potential risks of optic neuropathy with amiodarone, even at prescribed doses.

Area of Science:

Ophthalmology
Cardiology
Pharmacology

Background:

Amiodarone is a widely used antiarrhythmic drug.
Optic neuropathy is a known potential side effect of amiodarone.
Papilledema, or swelling of the optic disc, can be a sign of increased intracranial pressure or optic nerve dysfunction.

Observation:

Two patients developed papilledema within months of initiating amiodarone therapy.
Optic neuropathy manifested before any observable corneal toxicity.
The prescribed daily and weekly doses of amiodarone in these cases were reviewed.

Findings:

The early onset of papilledema suggests a potential direct toxic effect of amiodarone on the optic nerve.
The absence of concurrent corneal changes differentiates this presentation from typical amiodarone ocular toxicity.

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Review of existing meta-analysis and pathogenic mechanisms was conducted.

Implications:

Clinicians should be vigilant for early signs of optic neuropathy, including papilledema, in patients treated with amiodarone.
This finding may necessitate a re-evaluation of amiodarone dosing strategies and monitoring protocols.
Further research into the specific pathogenic mechanisms of amiodarone-induced optic neuropathy is warranted.