title: Amiodarone-associated optic neuropathy: a critical review.
abstract: Although amiodarone is the most commonly prescribed anti-arrhythmic drug, its use is limited by serious toxicities, including optic neuropathy. Current reports of amiodarone-associated optic neuropathy identified from the Food and Drug Administration's Adverse Event Reporting System and published case reports were reviewed. A total of 296 reports were identified: 214 from the Adverse Event Reporting System, 59 from published case reports, and 23 from adverse events reports for patients enrolled in clinical trials. Mean duration of amiodarone therapy before vision loss was 9 months (range 1-84 months). Insidious onset of amiodarone-associated optic neuropathy (44%) was the most common presentation, and nearly one third were asymptomatic. Optic disk edema was present in 85% of cases. Following drug cessation, 58% had improved visual acuity, 21% were unchanged, and 21% had further decreased visual acuity. Legal blindness (<20/200) was noted in at least one eye in 20% of cases. Close ophthalmologic surveillance of patients during the tenure of amiodarone administration is warranted.
authors.affiliation: Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
authors.forename: Rod S
authors.initials: RS
authors.lastname: Passman
authors.forename: Charles L
authors.initials: CL
authors.lastname: Bennett
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Purpura
authors.forename: Rashmi
authors.initials: R
authors.lastname: Kapur
authors.forename: Lenworth N
authors.initials: LN
authors.lastname: Johnson
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Raisch
authors.forename: Dennis P
authors.initials: DP
authors.lastname: West
authors.forename: Beatrice J
authors.initials: BJ
authors.lastname: Edwards
authors.forename: Steven M
authors.initials: SM
authors.lastname: Belknap
authors.forename: Dustin B
authors.initials: DB
authors.lastname: Liebling
authors.forename: Mathew J
authors.initials: MJ
authors.lastname: Fisher
authors.forename: Athena T
authors.initials: AT
authors.lastname: Samaras
authors.forename: Lisa-Gaye A
authors.initials: LG
authors.lastname: Jones
authors.forename: Katrina-Marie E
authors.initials: KM
authors.lastname: Tulas
authors.forename: June M
authors.initials: JM
authors.lastname: McKoy
mesh_terms: D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D001766:Blindness / Q000139:chemically induced / Q000209:etiology; D006801:Humans; D009901:Optic Nerve Diseases / Q000139:chemically induced* / Q000150:complications* / Q000175:diagnosis
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone