title: An Updated Review on the Most Common Agents Causing Toxic Optic Neuropathies.
abstract: Toxic optic neuropathies (TONs) often present with a gradual and bilateral decrease in visual acuity, scotomas and optic disc pallor. Obtaining an accurate history is the critical first step in determining the etiology of TONs.
  
  
  
  This updated review contains a thorough analysis of the current PubMed-indexed literature on the most common agents responsible for TONs, including methanol, ethambutol, amiodarone, linezolid, tumor necrosis factor alpha inhibitors and phosphodiesterase 5 inhibitors.
  
  
  
  The reviewed articles are mainly case reports presenting new and controversial aspects of the above agents. New treatment strategies, such as erythropoietin for methanol optic neuropathy, are being proposed for TONs, a condition that was previously regarded as untreatable.
  
  
  
  TONs could cause significant disability due to visual impairment. In case of early diagnosis and drug withdrawal, most TONs are treatable. Patients need to be appropriately counseled, and prescribing physicians should be especially made aware of TON-inducing medications.
authors.affiliation: Regional Specialist Hospital in Olsztyn. Poland.
authors.forename: Weronika
authors.initials: W
authors.lastname: Wasinska-Borowiec
authors.affiliation: Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran. Iran.
authors.forename: Kaveh Abri
authors.initials: KA
authors.lastname: Aghdam
authors.affiliation: Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4 C, PL 220, FI-00029 HUS, Helsinki. Finland.
authors.forename: Jukka Matias
authors.initials: JM
authors.lastname: Saari
authors.affiliation: Department of Ophthalmology, Poznan City Hospital, ul. Szwajcarska 3, 61-285 Poznan. Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Grzybowski
mesh_terms: D000638:Amiodarone / Q000009:adverse effects*; D004921:Erythropoietin / Q000627:therapeutic use; D004977:Ethambutol / Q000009:adverse effects*; D006801:Humans; D000069349:Linezolid / Q000009:adverse effects*; D000432:Methanol / Q000009:adverse effects*; D009901:Optic Nerve Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D058986:Phosphodiesterase 5 Inhibitors / Q000009:adverse effects*
chemical_list: D058986:Phosphodiesterase 5 Inhibitors; D004921:Erythropoietin; D004977:Ethambutol; D000069349:Linezolid; D000638:Amiodarone; D000432:Methanol
keywords: Amiodarone; ethambutol; linezolid; methanol; phosphodiesterase 5 inhibitors; toxic optic neuropathy; tumor necrosis factor alpha
  inhibitors