[Optic neuropathy while taking disulfiram].
BACKGROUND
Disulfiram has been used since the late 1940s to treat chronic alcoholism. This drug interferes with alcohol metabolism resulting in an acetaldehyde increase. This causes painful symptoms, encouraging abstinence. Side effects include rare cases of bilateral optic neuropathies. Visual recovery occurs frequently upon cessation of therapy.
We retrospectively studied patients referred for visual loss while treated with disulfiram between 1987 and 2005. Fourteen patients (three females, 11 males; aged 35-62 years) complained of visual loss, but a toxic, disulfiram-related, optic neuropathy was diagnosed in only five patients. Following cessation of disulfiram therapy, visual acuity and field improved in all five patients.


CONCLUSIONS
and conclusion: When disulfiram toxicity is suspected with optic neuropathy, cessation of treatment is mandatory. Visual prognosis is good in the majority of cases, as illustrated by our series. Disulfiram toxicity can be diagnosed only after excluding all other possible causes of visual loss.
Bessero
A-C
AC
Hôpital Ophtalmique Jules Gonin, Lausanne, Suisse.
Daeppen
J-B
JB
Borruat
F-X
FX
D000328:Adult; D000427:Alcohol Deterrents / Q000009:adverse effects*; D004221:Disulfiram / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000139:chemically induced*; D012189:Retrospective Studies
D000427:Alcohol Deterrents; D004221:Disulfiram