Toluene-Related Toxic Optic Neuropathy: A Case Report

The study aimed to present the clinical features and follow-up of a patient with toxic optic neuropathy after toluene exposure. A 35-year-old male patient was admitted with the complaint of painless vision loss in both eyes after exposure to inhaled cellulosic thinner. Visual acuities were measured at the level of counting fingers at 1 meter on the right and counting fingers at 10 centimeters on the left. The anterior segment was normal in both eyes. The fundoscopic examination revealed that optic disc borders and macula had a natural appearance in both eyes. Cranial computed tomography, diffusion magnetic resonance imaging (MRI), cranial MRI and orbital MRI were normal. As a result of the examinations, the patient was diagnosed with toxic optic neuropathy. In the 2-month follow-up of the patient pallor developed in both optic discs and optical coherence tomography imaging revealed atrophy in the ganglion cell complex and retinal nerve fiber layer thicknesses and bilateral centrocecal scotoma in the 30/2 humphrey Visual Field test. Although toxic optic neuropathy associated with toluene exposure is rare, it should be considered among other nutritional and toxic optic neuropathies because it causes permanent visual impairment.