Digoxin visual toxicity with therapeutic blood levels of digoxin.
OBJECTIVE
To report two cases of digoxin-related visual disturbances associated with therapeutic blood levels of digoxin.


METHODS
Case reports. One patient reported shimmering lights in the field of vision of both eyes; the second patient had a corrected visual acuity of BE, 20/40 and generalized visual field depression in both eyes. Both patients experienced these symptoms while receiving digoxin.


RESULTS
Both patients had digoxin blood levels in the therapeutic range (1.7 and 1.0 ng/ml, respectively). Therapeutic levels are 0.5 to 2.0 ng/ml. After discontinuing digoxin, the first patient noted that the shimmering light symptoms resolved, and the second patient had improved visual acuity and visual fields.


CONCLUSIONS
Digoxin-related visual toxicity may be associated with therapeutic blood levels of digoxin. Recognition of this entity may avoid unnecessary testing and frustration.
Wolin
M J
MJ
Neuro-ophthalmology, Anderson Eye and Ear Associates, SC 29627, USA. mjwolin@carol.net
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000097:blood*; D004077:Digoxin / Q000009:adverse effects* / Q000097:blood*; D005260:Female; D006801:Humans; D008875:Middle Aged; D014786:Vision Disorders / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology; D014792:Visual Acuity / Q000187:drug effects* / Q000502:physiology; D014794:Visual Fields / Q000187:drug effects / Q000502:physiology
D000889:Anti-Arrhythmia Agents; D004077:Digoxin