[Amiodarone treatment and visual prognosis].
BACKGROUND
Amiodarone is currently regarded as the most effective antiarrhythmic drug available for the treatment of tachyarrhythmias. Up to now, no recommendations exist concerning ophthalmological follow-up examinations at regular intervals of patients treated with amiodarone.


METHODS
We examined six patients with a mean age of 71.7 years (five men, one woman) who were treated with amiodarone.


RESULTS
One patient had no visual disturbances and a second patient had no permanent change of the optic nerve because treatment with amiodarone was discontinued in time. In one patient an abnormal blue colour vision was noticed. Swelling of the optic disc completely disappeared in five patients after discontinuing the drug. One patient revealed a posterior ischaemic optic neuropathy (PION). In two patients a unilateral change of the optic disc occurred. In three patients a severe irreversible lesion of the optic nerve was found at follow-up examination.


CONCLUSIONS
An insidious visual loss can occur with amiodarone treatment. A swelling of the optic disc without visual deterioration can occur as the first sign of a defect of the optic nerve. An abnormal blue colour vision can also be detected. After discontinuation of amiodarone either a visual improvement or a permanent deterioration may result. We recommend that every patient being treated with amiodarone should be observed by opthalmoscopy and colour vision examination at regular intervals (approximately every 3 months). Treatment with amiodarone should be discontinued after exclusion of life-threatening situations by a cardiologist, as soon as the first changes of the optic disc occur.
Schmidt
Dieter
D
Univ.-Augenklinik Freiburg. schmidtd@aug.ukl.uni-freiburg.de
D000368:Aged; D000369:Aged, 80 and over; D000638:Amiodarone / Q000008:administration & dosage* / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000187:drug effects*; D009901:Optic Nerve Diseases / Q000139:chemically induced* / Q000175:diagnosis; D018917:Optic Neuropathy, Ischemic / Q000139:chemically induced / Q000175:diagnosis; D011379:Prognosis; D012075:Remission, Spontaneous; D012307:Risk Factors
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone