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Digoxin toxicity. Recognizing the varied visual presentations

J R Piltz1, C Wertenbaker, S E Lance

  • 1Scheie Eye Institute, University of Pennsylvania School of Medicine, Philadelphia.

Journal of Clinical Neuro-Ophthalmology
|December 1, 1993
PubMed
Summary
This summary is machine-generated.

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Digoxin toxicity can cause decreased vision without xanthopsia. Lowering digoxin levels improves visual function, highlighting the importance of considering this toxicity in unexplained vision loss.

Area of Science:

  • Ophthalmology
  • Toxicology
  • Neuroscience

Background:

  • Digoxin is a cardiac glycoside used to treat heart failure and arrhythmias.
  • Classic visual symptoms of digoxin toxicity include xanthopsia (yellow vision).
  • Retinal dysfunction is increasingly implicated in the pathogenesis of digoxin toxicity.

Observation:

  • Three patients presented with decreased visual acuity due to digoxin toxicity.
  • Xanthopsia was notably absent in these cases.
  • One patient experienced visual symptoms exclusively, while another had complicated presentation due to retinitis pigmentosa.

Findings:

  • Visual function improved significantly after reducing blood digoxin levels.
  • Electroretinography (ERG) suggested cone dysfunction in one patient.

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  • These findings support retinal dysfunction as a mechanism in digoxin toxicity.

    • Implications:

    • Digoxin toxicity should be considered in patients with unexplained visual loss.
    • Ophthalmologists and neurologists may be the first to diagnose this condition.
    • Early recognition and management are crucial for potentially life-threatening digoxin toxicity.