Linezolid-associated optic neuropathy in a patient with ocular sarcoidosis.
BACKGROUND
We describe a case of bilateral linezolid-associated optic neuropathy in a patient with ocular sarcoidosis.


METHODS
A 70-year-old woman with sarcoidosis noted foggy vision in both eyes. Best-corrected visual acuity was 0.5 in the right eye and 0.9 in the left. No abnormality other than slight optic disc hyperemia was visible in either eye. A central scotoma in both eyes and enlargement of the blind spot in the right eye were detected by Goldmann perimetry examination, and magnetic resonance imaging demonstrated an edematous optic nerve in the right eye. Therefore, retrobulbar optic neuritis resulting from sarcoidosis was initially suspected. Sub-Tenon's capsule injection of triamcinolone acetonide along with steroid pulse therapy was given; however, best-corrected visual acuity worsened to 0.06 in the right eye and 0.08 in the left. Pulse therapy was discontinued on day 1, and the possibility of linezolid-associated optic neuropathy was speculated because linezolid had been given for methicillin-resistant Staphylococcus aureus osteomyelitis 2 years before by an orthopedist. After discontinuation of linezolid, best-corrected visual acuity improved to 0.8 in the right eye and 0.9 in the left, and the optic disc hyperemia in both eyes disappeared.


CONCLUSIONS
Our findings demonstrate that it is important for ophthalmologists as well as physicians and orthopedists to consider the possibility of optic neuropathy caused by long-term use of linezolid.
Kiuchi
Katsuji
K
Department of Ophthalmology, Osaka Saiseikai Izuo Hospital, Osaka, Japan. kkiuchi1@yahoo.co.jp
Miyashiro
Miki
M
Kitagawa
Chiemi
C
Wada
Sanae
S
D000081:Acetamides / Q000009:adverse effects*; D000368:Aged; D000890:Anti-Infective Agents / Q000009:adverse effects*; D005128:Eye Diseases / Q000150:complications*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D000069349:Linezolid; D008279:Magnetic Resonance Imaging; D016106:Methicillin Resistance; D009902:Optic Neuritis / Q000139:chemically induced* / Q000175:diagnosis; D010019:Osteomyelitis / Q000188:drug therapy / Q000382:microbiology; D023303:Oxazolidinones / Q000009:adverse effects*; D012507:Sarcoidosis / Q000150:complications*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests
D000081:Acetamides; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D000069349:Linezolid