Warning: Amiodarone and retinal neuropathy

Thanks to new member, Charlene for her alert about her tragic loss of sight due to Amiodarone.


Am J Med. 2012 May; 125(5): 447–453.

Amiodarone-Associated Optic Neuropathy: A Critical Review

Abstract

Although amiodarone is the most commonly prescribed antiarrhythmic 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 (FDA-AERS) and published case reports were reviewed. A total of 296 reports were identified: 214 from AERS, 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 disc 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.

Keywords: amiodarone, vision loss, optic neuropathy
[www.ncbi.nlm.nih.gov]

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Jackie

As an ophthalmologist specializing in cataract surgery, I see lots of patients on amiodarone- most of them have the common finding of cornea verticillata on exam. I have not seen the rare finding of
optic neuropathy, but tell these patients to notify the office immediately of any changes in vision.

I started to notice changes in my right eye and made an appointment with my Opthamologist. He is good friends with my cardiologist (not the partner that started me on the Amiodorone) - as I was sitting in his chair he called my cardiologist from his cell phone and told him he needed to discontinue my Amiodorone immediately. I was sent directly to see a retina specialist. I think I was the first patient he had seen with Amiodorone induced Optic Neruropathy.
Interestingly, I take Flecainide and I am the 1 in 10,000 patients that is photo sensitive to this drug. I am just very sensitive to any kind of drug .. Lucky Me

Charlene in Tulsa, OK
started this journey 05/06/2013
have chalked up 45 hours in AFib (3 events)
wish I didn't belong to this club
but grateful to find 'afib friends'

Charlene- there are some smart doctors in Oklahoma- your ophthalmologist is a good one. I may be a bit biased though- I'm a graduate of OU College of Medicine.